[Intraoperative right-to-left shunting induced by supine position in simultaneous lung resection with repair of atrial septal defect].

This report describes the case of a 49-year-old woman, who was suffered severe hypoxemia attributable to right-to-left shunting through an atrial septal defect (ASD) during the combined surgery for lung cancer and ASD in supine position. Right-to-left shunting has been reported to occur after lung resection but not during it. According to our continuous measurement of pulmonary arterial pressure and oxygen saturation, changes in hemodynamics during lobectomy in supine position was supposed to differ from that in lateral position, which may contribute to right-to-left shunting. A combined lung resection with heart surgery was performed safely and resulted in preventing postoperative complications induced by ASD.

[Preoperative assessment of myocardial ischemia in thoracic surgery for lung cancer].

BACKGROUND: Morbidity of myocardial ischemia in the thoracic surgery for lung cancer has been reported in the literatures, although, the risk of myocardial ischemia is not well identified preoperatively. OBJECTIVES: The aim of this study was to describe the prevalence of severe coronary stenosis in the thoracic surgery for lung cancer. METHODS: From January 2004 to December 2006, data were collected concerning 175 consecutive patients underwent lung resection for lung cancer. Prior to the surgery, we performed coronary angiography on the patients with either ischemic change in the exercise electrocardiogram (ECG) testing or comorbid conditions (current or previous smoking, hypertention, diabetes mellitus, hyperlipidemia or history of chest pain). RESULTS: Fifty-eight (33%) patients underwent coronary angiography. Coronary stenosis was detected in 19 patients (10.9%), including 6 patients (3.4%) with severe stenosis. These 6 patients received percutaneous coronary intervention or coronary artery bypass grafting prior to the lung resection, which resulted in no incidence of perioperative myocardial ischemia. Three of 6 patients with severe stenosis were negative for ischemic changes in exercise ECG testing. CONCLUSION: The prevalence of severe coronary stenosis is 3.4%, which is supposed to indicate the risk of perioperative myocardial ischemia in the thoracic surgery for lung cancer.

Genetic variations associated with diabetic nephropathy and type II diabetes in a Japanese population.

Genetic susceptibility plays an important role in the pathogenesis of diabetic nephropathy and type II diabetes. To identify the genetic polymorphisms associated with diabetic nephropathy and type II diabetes, we performed a genome-wide association study using single-nucleotide polymorphisms as genetic markers. We also analyzed polymorphisms within the genes encoding for the renin-angiotensin system that were considered as candidate genes for diabetic nephropathy susceptibility and the transcription factor 7-like 2 (TCF7L2) as a candidate for type II diabetes, in a large cohort of a Japanese population. A genome-wide association study identified SLC12A3 and engulfment and cell motility 1 gene as the new candidates for diabetic nephropathy and transcription factor-activating protein 2beta as a novel susceptibility gene for type II diabetes; this observation was based on the significant association between the polymorphisms within the genes and the corresponding diseases (P<0.0001). Further, we discovered that the genes encoding the angiotensin-converting enzyme, angiotensinogen, and angiotensin II type I receptor have a significant combinational effect on conferring susceptibility to diabetic nephropathy. Furthermore, TCF7L2 that has been reported as a convincing susceptibility gene for type II diabetes in Caucasian populations was also shown to be associated with type II diabetes in a Japanese population. These genes could be considered as strong susceptibility genes for diabetic nephropathy and type II diabetes in the Japanese, although the new candidates that have been identified by genome-wide screening need to be examined in greater detail by several replication studies.

Formation of PCDDs and PCDFs during the combustion of polyvinylidene chloride.

In laboratory-scale combustion of polyvinylidene chloride (PVDC) with a quartz tubular furnace designed and fabricated to provide the desired combustion temperature and mixing state of combustion gas with air, it was found that at 800 degrees C or higher the level of polychlorinated dibenzo-p-dioxins/polychlorinated dibenzofurans [corrected] (PCDDs/PCDFs) resulting from PVDC combustion was no higher than that from heating air alone, and thus far below the levels which resulted from PVDC combustion at 750 degrees C or lower. The results provide the first laboratory confirmation of the relation between PVDC incineration temperature and PCDD/PCDF formation, and of the primary importance of high temperature, turbulence for mixing between air and combustion gas, and sufficient residence time, as governing factors for the minimization of PCDD/PCDF formation in municipal solid waste incinerators.

Early and late recurrence after gastrectomy for gastric carcinoma. Univariate and multivariate analyses.

BACKGROUND: To the authors' knowledge, there are few studies regarding the predictors of early and late recurrence after gastrectomy for gastric carcinoma, and it is unknown whether prognostic factors can be applied to the timing of recurrence. The current study analyzed patients who died of recurrent gastric carcinoma and clarified histopathologic indicators associated with early and late recurrence. METHODS: The study included 138 patients who died of recurrent gastric carcinoma after gastrectomy that was performed in the Department of Surgery I, Oita Medical University, between 1982-1995. Clinicopathologic findings were compared between 104 patients who died within 2 years after gastrectomy (early recurrence group) and 34 patients who died > 2 years after gastrectomy (late recurrence group). Multivariate analysis was performed to determine the independent factors correlated with the timing of recurrence. RESULTS: When compared with the late recurrence group, the early recurrence group was characterized by a tumor size >/= 5 cm (92% in the early recurrence group vs. 74% in the late recurrence group), positive lymphatic invasion (64% vs. 38%), extended lymph node metastasis (73% vs. 35%), Stage III or IV disease (87% vs. 62%), and limited lymph node dissection (32% vs. 3%). The mean survival time was influenced by the lymphatic invasion (P < 0.01), vascular invasion (P < 0.05), level of lymph node metastasis (P < 0.01), stage of disease (P < 0.01), and extent of lymph node dissection (P < 0.01). On multivariate analysis, survival time was found to be associated independently with the stage of disease (Stage I, II vs. Stage III, IV) or the level of lymph node metastasis (N0, N1 vs. N2, N3). CONCLUSIONS: The stage of disease and level of lymph node metastasis were found to be the most significant factors independently associated with the survival time after gastrectomy for gastric carcinoma. Patients with more advanced stage of disease (Stage III, IV) or those with extended lymph node metastasis (N2, N3) frequently died of recurrence within 2 years after gastrectomy.

Feline coronavirus participation in diarrhea of cats.

Fecal samples were examined for viruses participated in gastrointestinal disorders of cats, especially focusing on feline coronavirus (FCoV) by a reverse transcriptase-polymerase chain reaction assay. It was found that a primary viral pathogen was feline panleukopenia parvovirus (FPLV; 28.5% of the positive rate) and the secondary was FCoV (10.7%). Commonly reported clinical signs of cats of which feces were FCoV-positive were vomiting, diarrhea and dehydration with an exception of one serious case with concurrent FPLV infection.

Evaluation of inner ear histology and auditory brainstem response in Wriggle Mouse Sagami.

Wriggle Mouse Sagami (WMS) is a spontaneous mutant strain with neuroepithelial defects. These animals are characterized by abnormal movements linked to an autosomal recessive gene. To determine the association between inner ear histology and hearing ability, we assayed these characteristics in mice homozygous and heterozygous for the mutation, as well as in wild-type animals. In homozygotes, the cochlea and saccule degenerated 3 months after birth. Beginning at 3 months of age, and progressing in an age-dependent manner, the organ of Corti disappeared and the number of spiral ganglion cells decreased, starting at the basal turn and moving toward the apical turn. The sensory epithelium became atrophic in the saccule. Three-month-old heterozygotes demonstrated degeneration in the cochlea, not in the saccule. No obvious auditory brainstem evoked response (ABR) was observed at any frequency in homozygotes aged 1 month and older. In contrast, the heterozygotes retained some hearing acuity until the age of 1 month, after which they became deaf. These findings suggest that WMS mice may provide a good model that will be useful in identifying deafness genes in humans.

Cloning and characterization of the nucleoredoxin gene that encodes a novel nuclear protein related to thioredoxin.

In a yeast artificial chromosome contig close to the nude locus on mouse chromosome 11, we identified a novel gene, nucleoredoxin, that encodes a protein with similarity to the active site of thioredoxins. Nucleoredoxin is conserved between mammalian species, and two homologous genes were found in Caenorhabditis elegans. The nucleoredoxin transcripts are expressed in all adult tissues examined, but restricted to the nervous system and the limb buds in Day 10.5-11.5 embryos. The nucleoredoxin protein is predominantly localized in the nucleus of cells transfected with the nucleoredoxin expression construct. Since the bacterially expressed protein of nucleoredoxin showed oxidoreductase activity of the insulin disulfide bonds with kinetics similar to that of thioredoxin, it may be a redox regulator of the nuclear proteins, such as transcription factors.

Screening of patients with maternally transmitted diabetes for mitochondrial gene mutations in the tRNA[Leu(UUR)] region.

To investigate the prevalence and clinical characteristics of diabetes mellitus caused by mitochondrial gene mutations in the tRNA[Leu(UUR)] region, a known 'hot spot' for pathogenic mutations, we screened 440 diabetic patients with diabetic mothers for 11 mitochondrial gene mutations reported in mitochondrial neuromuscular disorders; nucleotide pairs (np) 3250, 3251, 3252, 3254, 3256, 3260, 3271, 3291, 3302 and 3303 in addition to an A to G transition at np 3243. The dot-blot hybridization method using 32P-labelled sequence-specific oligonucleotides as probes was used. One subject carrying a T to C transition at np 3271 and seven carrying the A to G transition at np 3243 were identified, while none of the other diabetic patients screened had these mutations in the tRNA[Leu(UUR)] region. The patient with the 3271 mutation, a 39-year-old male, had excellent glycaemic control with diet alone and had neither hearing impairment nor symptoms suggesting mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS). Thus, among patients with maternally transmitted diabetes, the prevalence of the 3271 mutation was approximately one-seventh that of the 3243 mutation, and other mutations are even more rare in the mitochondrial tRNA[Leu(UUR)] region.

Prognostic significance of the p53 mutation in esophageal cancer.

In the esophagus, alterations in the p53 tumor suppressor gene are associated with the development of preinvasive neoplastic lesions to invasive carcinoma. The role of p53 gene mutation in the progression of esophageal cancer still remains unclear. In this study, 82 DNA samples extracted from formalin-fixed, paraffin-embedded esophageal cancer tissues were analyzed for p53 mutation by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis. All the patients had been treated surgically and were Japanese. Exons 5 through 8 of the p53 gene were amplified in DNAs and the mutations detected in 28 cases (34%) did not correlate with tumor location, histopathologic classification, histologic depth of tumor invasion, lymph node involvement or clinical stage. Among 39 patients with stage 3 and 4 disease who had undergone radical esophageal resection, those with p53 mutation had a poorer prognosis, the two-year survival being 25.4% compared with 61.2% for those without p53 mutation (P<0.01). These results suggest that p53 gene mutations play an important role not only in the genesis but also the progression of human esophageal cancer.

Correction of the QT interval in children.

We evaluated the usefulness of 11 formulas for correcting the QT interval in children, including the square root, cubic root, logarithmic, linear, exponential, and inverse formulas using the Mean-squared residual (MSR) values and Akaike Information Criterion (AIC) in 8,086 first-graders, 9,989 seventh-graders, and 5,786 tenth-graders. The subjects were divided into six groups according to age and sex. MSR and AIC values were lowest in all of the groups for the exponential formula (eQTc) and Fridericia's formula (fQTc). We then evaluated the relative usefulness of these two formulas by determining the optimal value for parameter k using the following exponential model: eQTc = (QT interval)/(RR interval)k. The best-fit value for k was different for each group. However, the tentative abnormal eQTc and fQTc values, determined by statistical analysis, were equivalent in all groups when 0.31 was used as the exponential parameter k. These results suggest that the exponential formula and Fridericia's formula are equally useful for screening for QT prolongation.

[Trace elements analysis of serum and cerebrospinal fluid with PIXE--effect of age and changes in parkinsonian patients].

The concentrations of Br, Cu, Fe, Se, Zn, Mg were determined by particle-induced X-ray emission (PIXE) in serum and cerebrospinal fluid (CSF) of 13 untreated, 7 L-dopa treated parkinsonian patients and 25 controls. There were significant positive correlations between serum concentrations and CSF concentrations of Br, Cu, Fe. The Cu/Zn ratio in the serum and the CSF/serum ratio of Br were significantly increased with age in normal controls. The mean CSF concentration of Mg in both treated and untreated parkinsonian patients was lower than in controls. PIXE is a valuable method for multielemental analysis of the serum and CSF.

Amino acid-induced responses in CNS neurons of normal mouse and Wriggle Mouse Sagami.

Amino acid-induced responses and their regional heterogeneities in the motor cortical and hippocampal (CA1) neurons of normal mouse and Wriggle Mouse Sagami (WMS) were studied by conventional patch-clamp techniques. There were no differences in the current densities and EC50s of glutamate-, gamma-amino butyric acid (GABA)-, and glycine-induced responses between the two groups of mice. In both types of mice, the GABA-induced current density of cortical neurones was higher and EC50 was lower than in hippocampal neurones, whereas the responses induced by glycine and glutamate did not show any differences.

Oxygen-independent antimicrobial activity against Salmonella enteritidis of specially activated macrophage with living vaccine.

Characteristics of peritoneal macrophages recovered from mice infected with two attenuated strains SER and Jena of Salmonella enteritidis were compared. Strong resistance against lethal infection with a virulent strain 116-54 of S. enteritidis was seen in a group of mice immunized with strain SER, but not in a group of mice immunized with strain Jena as well as in a control group. Peritoneal macrophages from mice immunized with strain SER showed an enhanced Salmonella-killing activity, an increased generation of O2- and an increased expression of Ia antigen on 7 to 14 days after infection when compared with those from mice immunized with strain Jena and thioglycollate(TG)-elicited macrophages as a control. The bacterial number of strain Jena in organs decreased more rapidly than that of strain SER after day 4 of infection. These observations suggest that the survival of an attenuated Salmonella bacilli at reticulo-endothelium is essential to increase of their activities of macrophages. Macrophages from mice injected with recombinant interferon(IFN)-gamma for 3 days induced the activated stage of the same characteristics as noted in activated macrophages from mice immunized with strain SER. Effect of oxygen intermediates (OI) scavengers such as superoxide dismutase and catalase on Salmonella-killing activity of activated macrophages was not seen at all. These results suggest that an increased generation of OI may be not primarily responsible for the ability to inhibit the intracellular growth of a virulent strain of S. enteritidis in macrophages activated by immunization with live, attenuated strains and injection with rIFN-gamma.

Mapping of the nu gene using congenic nude strains and in situ hybridization.

The chromosomal location of the nu gene, which is responsible for hairlessness and athymus, was determined using six DNA markers (interleukin 3 [Il-3], Myhs, Acrb, Evi-2, Mpo, and Hox-2) on mouse chromosome 11. We constructed the high-resolution physical mapping of the six DNA markers on chromosome 11 by in situ hybridization using fluorescence-labeled cosmid probes. The results indicate the order of centromere-(41cM)-Il-3-(3cM)-Myhs- (4cM)-Acrb-(6cM)-Evi-2-(3cM)-Mpo-(5cM)- Hox-2. We have used congenic nude strains and examined which of the six DNA markers were derived from the original nude mouse. We found the Evi-2 locus is linked to the nu gene in all the informative, independent congenic nude strains. From these data, we could estimate the location of the nu gene, not only genetically but also physically within a region that spans approximately 17 megabases (9 cM) between the Acrb and Mpo genes.