Prognostic value of power doppler ultrasonography for equine superficial digital flexor tendon injury in thoroughbred racehorses.

The potential value of hypervascularity detected with power Doppler ultrasonography (PDU) within equine superficial digital flexor tendon (SDFT) as a prognostic factor of SDFT injury is not clear. The purpose of this study was to test the hypothesis that hypervascularity within SDFT is one of the risk factors for subsequent severe SDFT injury and to evaluate the prognostic value. A prospective cohort study of 97 Thoroughbred racehorses without any clinical signs of SDFT injury was conducted. Six variables of age, body weight, sex, the cross-sectional area of SDFT, PDU signal within SDFT and experience of steeplechase were assessed for the possibility of risk factors of subsequent SDFT injury in follow-up period of 1 year. Multivariable logistic regression analyses were used for assessment of the odds ratios (ORs) and 95 % confidence intervals (CIs) of SDFT injury. Multivariable logistic regression analysis revealed that the PDU signal within SDFT was a risk factor for the development of SDFT injury in follow-up period (P = 0.017). The adjusted OR of SDFT injury was significantly higher in PDU positive group than in PDU negative group (OR 3.17, 95 % CIs 1.20-8.35). Although further studies are required, these results would be useful for early detection and/or prevention of development for clinical severe SDFT injury.

5-HT3 receptor antagonists ameliorate 5-fluorouracil-induced intestinal mucositis by suppression of apoptosis in murine intestinal crypt cells.

BACKGROUND AND PURPOSE: Chemotherapeutic agents, including 5-fluorouracil (5-FU), frequently cause intestinal mucositis resulting in severe diarrhoea and morphological mucosal damage. 5-HT3 receptor antagonists are clinically effective in the treatment of nausea and emesis during cancer chemotherapy. Therefore we here have examined the effects of 5-HT3 receptor antagonists on 5-FU-induced intestinal mucositis in mice. EXPERIMENTAL APPROACH: Intestinal mucositis was induced in male C57BL/6 mice by daily administration of 5-FU (50 mg·kg⁻¹) for 5 days. Effects of 5-HT3 receptor antagonists, ramosetron (0.01-0.1 mg·kg⁻¹) and ondansetron (5 mg·kg⁻¹), on the accompanying histology, cytokine production and apoptosis were assessed. KEY RESULTS: Continuous administration of 5-FU to mice caused severe intestinal mucositis, which was histologically characterized by the shortening of villi and destruction of intestinal crypts, accompanied by body weight loss and diarrhoea. Daily ramosetron administration dose-dependently reduced the severity of intestinal mucositis, body weight loss and diarrhoea. Similar beneficial effects were observed with ondansetron. The number of apoptotic, caspase-3- and caspase-8-activated cells increased 24 h after the first 5-FU administration, and these responses were reduced by ramosetron. The up-regulation of TNF-α, IL-1ß and IL-6 following 5-FU treatment was also attenuated by ramosetron. CONCLUSIONS AND IMPLICATIONS: 5-HT3 receptor antagonists ameliorated 5-FU-induced intestinal mucositis in mice, and this action could result from suppression of apoptotic responses in the intestinal crypt cells via inhibition of cytokine expression. Thus, 5-HT3 receptor antagonists may be useful for preventing not only nausea and emesis but also intestinal mucositis during 5-FU chemotherapy.

[Antimicrobial susceptibility pattern and epidemiological investigation of the clinical isolates of Pseudomonas aeruginosa in 1999and 2000].

During 1999-2000, a total of 1,215 isolates of Pseudomonas aeruginosa (P. aeruginosa) were analyzed by wards, type of clinical specimens and serotypes. Antimicrobial susceptibility was also examined for 10 agents (PIPC, CAZ, LMOX, IPM-CS, GM, AMK, MINO, LVFX, NFLX, and ST) with criteria by NCCLS (M7-A5). Sputum (33%) was most common source of P. aeruginosa followed by urine (17) and wound discharge (14%). According to wards, the isolation rate at the critical care unit was the highest (40%) in 1999 but decreased to 14% in 2000. In the isolates from inpatients (1999, 2000) the resistance rate was 96.8-98.9% for MINO and ST, 23.5-30.8% for IPM-CS, 27.2-28.9% for LMOX, 12.5-20.1% for GM, and 6.7-11.8% for NFLX. Comparison between the two years showed increases in isolates resistant to GM (p<0.01) and NFLX (p<0.05) but a decrease in IPM-CS resistant isolates (p<0.01). According to serotypes, the E and G type were most frequently observed (242 isolates each, 21.8%) followed in order by F type (127 isolates, 11%) and the B type (124 isolates, 11%). The incidence of the F type was high compared with other medical institutions. There was a reduction in the rates of susceptibility of serotype E isolates to PIPC (74.4%) and GM (60.3%), and of serotype F isolates to IPM-CS (52%). Multidrug-resistant P. aeruginosa (MDR-PSA) that were resistant to beta-lactams, aminoglycosides, and new quinolons accounted for 3%.

Isolation of Rhizopus microsporus var. rhizopodiformis in the ulcer of human gastric carcinoma.

Gastric zygomycosis in a patient with gastric cancer was described. Colonization was diagnosed because broad sparsely septate hyphae were identified in the necrotic tissue of gastric biopsied specimens. No fungus was present within viable tissue. Positive cultures for Rhizopus microsporus var. rhizopodiformis were obtained from fragments of biopsied specimens. Members of the Mucorales have rarely been isolated from the culture of endoscopically biopsied materials.

Lymphocutaneous nocardiosis with multiple subcutaneous nodules distributed over the extensor aspect of the forearm. Report of a case.

We report a case of lymphocutaneous nocardiosis due to Nocardia brasiliensis, marked by multiple subcutaneous nodules and abscesses on the extensor aspect of the left forearm in a 53-year-old woman with systemic lupus erythematosus. Nine months before she was first examined, she had fallen on a concrete surface. A nodule had appeared 2 months later at the same site and had expanded and been followed by others, which finally covered most of the extensor aspect of the forearm. We speculated that the bacteria may have been conveyed retrogradely via the lymph vessels in a distal direction, perhaps as a result of the trauma and the subsequent development of an intradermal lesion.

Lysophosphatidic acids induce proliferation of cultured vascular smooth muscle cells from rat aorta.

Lysophosphatidic acids (LPA) with a C18 fatty acyl group accelerated thymidine incorporation into cultured rat aortic vascular smooth muscle cells and stimulated their cell division. LPA acted synergistically with epidermal growth factor and fibroblast growth factor but additively with platelet-derived growth factor. The stimulatory actions of LPA were suggested to be rather specific from the following findings: 1) their stimulation of DNA synthesis increased with an increase in their acyl moiety; 2) lysophosphatidylcholine, a neutral lysophospholipid, had no mitogenic action but was cytotoxic at high concentrations; and 3) LPA induced a rapid external Ca(2+)-independent increase in intracellular Ca2+ concentration ([Ca2+]i) in single fura 2-loaded cells that resembled the receptor-mediated increases in [Ca2+]i triggered by different agonists, whereas lysophosphatidylcholine provoked a slow sustained increase in [Ca2+]i in an external Ca(2+)-dependent manner. These results are discussed in relation to the possible pathophysiological role of LPA.

Platelet-aggregating effects of platelet-activating factor-like phospholipids formed by oxidation of phosphatidylcholines containing an sn-2-polyunsaturated fatty acyl group.

Previously, we reported the formation of four kinds of phosphatidylcholines (PC) with a short-chain monocarboxylate, dicarboxylate, dicarboxylate semialdehyde or omega-hydroxymonocarboxylate group by oxidation of PCs containing polyunsaturated fatty acid (PUFA) in an FeSO4/ascorbate/EDTA system. In this study, we identified these novel phospholipids by GC-MS as oxidation products of two alkyl ether-linked PCs, 1-O-hexadecyl-2-docosahexaenoyl and 1-O-hexadecyl-2-arachidonoyl-sn-glycero-3- phosphocholine (GPC). The sn-2-acyl moieties of oxidatively fragmented PCs derived from PCs containing docosahexaenoate were one methylene unit shorter than those detected as major oxidation products of PCs containing arachidonate. The platelet-aggregations induced by the oxidized PCs were all inhibited by FR-900452, an antagonist of platelet activating factor (PAF). The PAF-like activity of oxidized 1-O-hexadecyl-2-docosahexaenoyl-GPC, which was equivalent of 1372 +/- 262 pmol 16:0-PAF/mumol starting PC, was 5 times that of oxidized 1-O-hexadecyl-2-arachidonoyl-GPC and 150 times that of oxidized 1-palmitoyl-2-docosahexaenoyl-GPC, suggesting that both an sn-1-alkyl ether linkage and an sn-2-acyl group with a short chain length are important structural requirements for induction of platelet aggregation. These possibilities were confirmed by experiments on the platelet-aggregating activities of synthetic PAF-like compounds. Quantitative measurements by GC-MS of PAF-like phospholipids formed by lipid peroxidation and the activities of synthetic PAF-like phospholipids, suggested that the activities of most oxidized PCs containing PUFA were ascribable to those of PCs with an sn-2-short-chain monocarboxylate group.

[Intestinal flora of inpatients and isolation frequency of methicillin-resistant Staphylococcus aureus].

The authors compared intestinal flora from 30 healthy volunteers and 128 inpatients. E. coli, B. fragilis, and Bifidobacterium were each detected in the stools of healthy subjects at a frequency of more than 90%, while the incidences of such flora were low in the stools of inpatients: A significant difference was observed between the two groups. E. faecium, P. aeruginosa, Methicillin-resistant Staphylococcus aureus (MRSA), C. difficile, and Candida were detected at high frequencies in the stools of inpatients, as compared with healthy subjects. This finding is attributed to the administration of antimicrobial agents. It is also considered that microbial interaction in maintaining the balance among normal intestinal flora had been lost in patients from whom MRSA and/or C. difficile was isolated. The decrease or elimination of bacterial species antagonistic to such resistant strains must be guarded against, because this can lead to weakening of the defence mechanism against intestinal infection.

Pulmonary aspergillosis due to Aspergillus terreus combined with staphylococcal pneumonia and hepatic candidiasis.

A female patient with systemic lupus erythematosus (SLE) developed pulmonary aspergillosis with staphylococcal pneumonia and hepatic candidiasis. Aspergillus terreus, which is a rare causative organism of pulmonary aspergillosis, was identified from a pulmonary lesion by culture. The aleurioconidium production, a characteristic of the genus Aspergillus sect. terrei, was demonstrated on short and irregular hyphal features in tissue sections. This report is the first of a combined case of pulmonary aspergillosis due to A. terreus with infections caused by other microorganisms.

Effects of high energy shock wave exposure on renal function during extracorporeal shock wave lithotripsy for kidney stones.

In order to study the effects of high energy shock wave exposure on the kidney in extracorporeal shock wave lithotripsy (ESWL) using Dornier HM3, renal hemodynamics and renal function before and after ESWL were analyzed by 99mTc-DTPA renoscintigraphy. Various urinary enzyme activities (LDH, GOT, GPT, NAG, gamma-GTP) and low molecular protein concentrations (alpha 1-microglobulin, beta 2-microglobulin) before and after ESWL were also compared. In the early phase of the renoscinitgram obtained in the 1st min after injection of 99mTc-DTPA, the time required to reach maximum radioactivity was significantly prolonged after ESWL in both the affected and contralateral kidney. This indicated that renal blood flow decreased in both the affected and contralateral kidney immediately after ESWL. An analysis of the 30-min renoscintigram showed that urinary clearance was delayed in the affected kidney in spite of no overt obstruction due to stone fragments. As for urinary enzyme activities and low molecular protein concentrations, they were standardized by urinary creatinine concentration measured at the same time. Urinary LDH, GOT, GPT and NAG activities remarkably increased on the day of ESWL followed by a decrease close to pretreatment levels on the 4th day, though these levels were still significantly higher than pretreatment levels. Urinary gamma-GPT activity was significantly higher than the pretreatment level only on the day of ESWL. Urinary alpha 1-microglobulin and beta 2-microglobulin concentrations significantly increased on the day of ESWL and were still high on the 4th day.(ABSTRACT TRUNCATED AT 250 WORDS)

Two years clinical experiences with extracorporeal shock-wave lithotripsy and transurethral ureterolithotripsy for ureteral stones at Osaka City University Hospital.

From July 1985 to June 1987, 303 patients with ureteral stones were treated by either extracorporeal shock-wave lithotripsy (ESWL) or transurethral ureterolithotripsy (TUL). The ureteral stones were classified into two groups, upper and lower ureteral stones. The upper ureteral stone was defined as a stone located above the pelvic brim in radiological examinations. ESWL was performed using a Dornier lithotriptor HM-3. For TUL, following the insertion of a guide wire and dilatation of the intramural ureter by ureteral bougie, a ureteroscope was introduced into the ureter. The success rate included both patients who became stone free and patients whose stones were disintegrated into less than 4 mm. The success rate of ESWL for upper ureteral stones was 90%, and 8.5% were treated subsequently by TUL. The success rate of TUL for upper ureteral stones was 42%, and the remaining required another session of TUL or another procedure, mainly ESWL. On the other hand, the success rate of TUL for lower ureteral stones was 71%, and the remainder also required another session of TUL or another procedure, mainly ESWL. The efficacy of TUL for stone street was comparably low by the evaluation done at 5 days after the procedure. However, almost all patients with stone street, which had developed after ESWL treatment, became stone free several weeks after TUL and insertion of a stent catheter. Major complications or side effects for ESWL were fever of more than 37.5 degrees C (7.5%) and pain attacks (8.9%).(ABSTRACT TRUNCATED AT 250 WORDS)

[The antibacterial activity of new cephem antibiotics against clinical isolates. A comparison of the antibacterial activity of cefotaxime with 6 other antibiotics].

During the period from May through July 1981, a comparative study was carried out on the antibacterial activities of cefotaxime (CTX) and ceftizoxime (CZX), cefoperazone (CPZ), latamoxef (LMOX), cefotiam (CTM), cefmetazole (CMZ) and cefazolin (CEZ). CTX and these other cephem antibiotics were tested against fresh clinical isolates which had been obtained from clinical materials by the laboratories of 14 participating medical institutions. 1. The clinical isolates were obtained from various clinical materials in the following decreasing order: urine, sputum and pus/discharge; 85.7% of the isolates came from these materials. 2. Concerning the sources of each species of clinical isolates, it was found that P. aeruginosa was isolated from the greatest number -9- of different clinical materials. This was followed by E. coli and E. cloacae, each isolated from 8 different clinical materials, and C. freundii and E. aerogenes, each found in 7 different clinical materials. 3. In relation to S. pyogenes, S. agalactiae and S. pneumoniae, CTX showed the best antibacterial activity; the second most potent antibiotic was CZX. CMZ and LMOX were found to show relatively high MIC values for those species. Against S. aureus, CEZ showed the best antibacterial activity, but 3 resistant strains had MICs of greater than 100 micrograms/ml. 4. With regard to Gram-negative bacteria, CTX and CZX showed the best antibacterial activities for all of the species, except for P. aeruginosa. These were followed, in order, by LMOX and CPZ. Compared with these 4 antibiotics, CTM, CMZ and CEZ were found to have inferior antibacterial activities against these bacteria. In relation to P. aeruginosa, the peak of the MIC distribution for CPZ was 6.25 micrograms/ml, and this was the best antibacterial activity detected with the various antibiotics tested. This was followed by CTX (25 micrograms/ml) LMOX (25 micrograms/ml) and CZX (50 micrograms/ml). CTM had an MIC of 100 micrograms/ml for 1 strain, and MICs of greater than 100 micrograms/ml for all of the other strains of P. aeruginosa, indicating them to be resistant to this antibiotic. All of the strains were resistant to CMZ and CEZ, showing MICs of greater than 100 micrograms/ml. 5. For each of the tested antibiotics, no correlation was found between the MIC and the serogroup for either P. aeruginosa or S. marcescens.

Clinical and electroencephalographic study of temporal lobe status.

1. The temporal lobe status appears at a rate of once every 3-5 minutes. 2. The duration of a single temporal lobe seizure is varied, ranging from 10 seconds to 140 seconds. 3. The EEG during seizures is characterized by a generalization of 15-32 Hz recruiting epileptic rhythm which may become 3-7 Hz slow waves later in some cases, 3-7 Hz paroxysmal rhythmic waves. 4. The clinical symptoms are colorful, including apnic seizures, verbal automatism, facial muscle twitching, versive seizure and tonic seizure. The clinical symptoms depend on the size and depth of focus and the scope of propagation of discharge. 5. Generalization cannot be attained merely by the firing of focus that has been formed secondarily. The firing of primary focus is indispensable as the condition for generalization. 6. The focus depends more on the time of the disappearance of discharges than on the site of the primary onset of paroxysm. Particularly important is the length of duration of ictal discharges. 7. The cortico-cortical synapse and the cortico-subcortical pathways were considered the sources of epileptic propagation.