Psychological and endocrine factors and pain after mastectomy.

BACKGROUND: This prospective study was designed to examine the associations of demographic, clinical, psychological and neuroendocrine factors with acute and chronic post-operative pain following partial mastectomy. METHODS: Sixty-four female patients scheduled for partial mastectomy were enrolled. Pre-operative anxiety/depression was assessed, using the Hospital Anxiety and Depression Scale (HADS). Pre-operative 24-h urinary cortisol levels were measured 2 days before surgery. Post-operative pain was examined using a visual analog scale (VAS) for acute pain on 0-2 post-operative day (POD), and a short-form McGill Pain Questionnaire for chronic pain at 6 months after surgery. In the last 29 subjects, post-operative 24-h urinary cortisol levels were also measured on 0 POD and were subjected to correlation analysis. RESULTS: Multivariate logistic regression analysis revealed that lower pre-operative cortisol secretion and greater pre-operative anxiety were significantly associated with an increased risk of moderate to severe acute post-operative pain [Odds Ratio (95% Confidence Interval); 0.96 (0.92-0.98), and 1.24 (1.04-1.54)], and that patients with greater pre-operative anxiety and moderate to severe acute pain were more likely to develop chronic post-operative pain [OR (95% CI); 1.63 (1.23-2.40), and 5.07 (1.30-24.6)]. Correlational analysis demonstrated that the post-operative cortisol level was inversely correlated with pre-operative anxiety and the intensity of acute post-operative pain (r = -0.40, p < 0.05, and r = -0.50, p < 0.01), but not with the intensity of chronic pain. CONCLUSIONS: This study confirms that pre-operative anxiety is associated with both acute and chronic post-operative pain after partial mastectomy. It also suggests that lower perioperative cortisol secretion might be associated with greater acute post-operative pain. SIGNIFICANCE: Although the associations between psychological stress/stress hormone levels and chronic post-operative pain remain to be determined, pre-operative psychological stress and perioperative cortisol levels are correlated with acute post-operative pain.

Detection of the MYD88 mutation by the combination of the allele-specific PCR and quenching probe methods.

INTRODUCTION: The MYD88 missense mutation c.794T>C, p.Leu265Pro, is found in patients with Waldenstörm's macroglobulinemia and lymphoma. Direct sequencing, allele-specific PCR (AS-PCR), PCR-restriction fragment length polymorphism (PCR-RFLP), and high-resolution melting analysis (HRM) are currently used to detect the mutation; however, they are either time-consuming or have low detection sensitivity. Here, we developed a novel highly sensitive and rapid detection method based on the quenching probe (QP) technique and AS-PCR. METHOD: A lymphoma cell line heterozygous for the MYD88 mutation, two wild-type cell lines, and two samples from Waldenstörm's macroglobulinemia patients were analyzed by AS-PCR, PCR-RFLP, HRM, and QP, and their detection sensitivity was examined using the mixtures of the mutant and wild-type DNA. RESULTS: For mutation-carrying heterozygous samples, the QP method produced W-shaped melting profiles presenting curves derived from the wild-type and mutant alleles. The QP analysis was performed in 2 h and demonstrated the detection limit of 5%, which was similar to that of the other methods. However, the combination of AS-PCR and QP (AS-QP) improved the sensitivity to 0.62% of the mutant allele. CONCLUSION: The AS-QP analysis is rapid and minimally improves detection sensitivity compared to the AS-PCR.

Intra- and postoperative low-dose ketamine for adolescent idiopathic scoliosis surgery: a randomized controlled trial.

BACKGROUND: In this randomized controlled trial, we examined whether intra- and postoperative infusion of low-dose ketamine decreased postoperative morphine requirement and morphine-related adverse effects as nausea and vomiting after scoliosis surgery. METHODS: After IRB approval and informed consent, 36 patients, aged 10-19 years, undergoing posterior correction surgery for adolescent idiopathic scoliosis, were randomly allocated into two groups: intra- and postoperative ketamine infusion at a rate of 2 µg/kg/min until 48 h after surgery (ketamine group, n = 17) or infusion of an equal volume of saline (placebo group, n = 19). All patients were administered total intravenous anesthesia with propofol and remifentanil during surgery and intravenous morphine using a patient-controlled analgesia device after surgery. The primary outcome was cumulative morphine consumption in the initial 48 h after surgery. Pain scores (Numerical Rating Scale, NRS, 0-10), sedation scales, incidence of postoperative nausea and vomiting (PONV), and antiemetic consumption were recorded by nurses blinded to the study protocol for 48 h after surgery. RESULTS: Patient characteristics did not differ between the two groups. Cumulative morphine consumption for 48 h after surgery was significantly lower in the ketamine group compared to the placebo group (0.89 ± 0.08 mg/kg vs. 1.16 ± 0.07 mg/kg, 95% confidence interval for difference between the means, 0.03-0.48 mg/kg, P = 0.019). NRS pain, sedation scales, and incidence of PONV did not differ between the two groups. Antiemetic consumption was significantly smaller in ketamine group. CONCLUSIONS: Intra- and postoperative infusion of low-dose ketamine reduced cumulative morphine consumption and antiemetic requirement for 48 h after surgery.

Mapping of a quantitative trait locus for beef marbling on bovine chromosome 9 in purebred Japanese black cattle.

The goal of this study is to detect quantitative trait loci (QTL) for carcass traits applicable for a DNA-based breeding system in a Japanese Black cattle population. A purebred paternal half-sib family from a commercial line composed of 65 steers was initially analyzed using 188 informative microsatellites giving a 16-cM average interval covering 29 autosomes. A significant QTL for marbling was detected in the centromeric portion of bovine chromosome (BTA) 9. After additional marker genotyping across a larger sample size composed of 169 individuals, this locus was refined to a 20-cM confidence interval between microsatellites BM1227 (24 cM) and DIK2741 (50 cM) at a 1% chromosome-wise threshold. The allele substitution effect between Q and q for a beef marbling standard score (1 to 12 range) on BTA9 was 1.0 (5.7% of total phenotypic variance in QTL contribution in this family). This result provides a primary platform for a marker-assisted selection system of the beef marbling trait within the Japanese Black (Wagyu) cattle population.

Oligogenic transmission of abnormal teat patterning phenotype (ATPP) in cattle.

Abnormal teat patterning phenotype (ATPP) is characterized by one (moderate form) or two (severe form) absent teats in cattle. Using an allele-sharing non-parametric linkage strategy, significant associations with severe ATPP animals were detected on BTA17 (Z(max) = 7.3 at 21 cM), centromeric BTA1 (Z(max) = 3.7 at 8 cM) and telomeric BTA1 (Z(max) = 4.8 at 142 cM). The BTA17 region was also significantly associated in the analysis of the moderate ATPP animals (Z(max) = 5.3 at 0 cM). The transmission disequilibrium test in severe ATPP animals demonstrated significant over-transmission of paternal alleles in the BTA17 region (P = 2.2 x 10(-9)), the centromeric BTA1 region (P = 0.035) and the telomeric BTA1 region (P = 0.005). Significant over-transmission of the BTA17 region was also observed among the moderate ATPP animals (P = 2.3 x 10(-4)). These findings indicate that the BTA17 locus plays a key role in risk of the disease, and that the BTA17 locus contributes temporally in combination with the two other loci on BTA1 and/or possibly unknown modifier(s) in a probabilistic oligo- or polygenic manner of transmission. Haplotypes of these three loci can be used for marker-assisted animal breeding to control the recurrence of affected progeny with ATPP.

An integrated radiation hybrid map of bovine chromosome 18 that refines a critical region associated with multiple ocular defects in cattle.

Congenital multiple ocular defects (MOD) of Japanese black cattle is a hereditary ocular disorder with an autosomal recessive mode of inheritance showing developmental defects of the lens, retina and iris, persistent embryonic eye vascularization and microphthalmia. The MOD locus has been mapped by linkage analysis to a 6.6-cM interval on the proximal end of bovine chromosome 18, which corresponds to human chromosome 16q and mouse chromosome 8. To refine the MOD region in cattle, we constructed an integrated radiation hybrid (RH) map of the proximal region of bovine chromosome 18, which consisted of 17 genes and 10 microsatellite markers, using the SUNbRH7000 panel. Strong conservation of gene order was found among the corresponding chromosomal regions in cattle, human and mouse. The MOD-critical region was fine mapped to a 59.5-cR region that corresponds to a 6.3-Mb segment of human chromosome 16 and a 4.8-Mb segment of mouse chromosome 8. Several positional candidate genes, including FOXC2 and USP10, were identified in this region.

Linkage analysis reveals two independent loci for ocular disorders in a local Japanese Black cattle population.

A vision-impairing ocular disorder was observed in a local Japanese Black cattle population, and assumed to be an autosomal recessive disease based on the presence of a founder cow. A genome scan using seven affected half-sib pairs revealed a linkage to BTA5 (Z(max) = 7.0, LOD(max) = 2.0), designated the bovine ocular disorder 1 (bod1) locus. Of the seven animals, three were heterozygous at the bod1 locus. Analysis in these three animals revealed linkage to markers on BTA18, and this locus was designated bod2. Detailed haplotype inspection of 16 affected animals indicated linkage to BTA5 in 12 animals, BTA18 in three animals, and linkage to both BTA5 and BTA18 in one animal. The bod1 locus was mapped to a 25 cM interval between DIK5237 and DIK5210 on BTA5 (Z(max) = 17.0, LOD(max) = 11.8), and bod2 was mapped to a 7 cM interval between DIK5411 and INRA038 on BTA18 (Z(max) = 13.0, LOD(max) = 4.0). This study demonstrated that the independent involvement of loss of function mutations in two loci is likely responsible for this genetic heterogeneity.

Enzymatic synthesis of a catechin conjugate of polyhedral oligomeric silsesquioxane and evaluation of its antioxidant activity.

The antioxidant activity of catechin was amplified by conjugation with amine-terminated polyhedral oligomeric silsesquioxane (POSS) using horseradish peroxidase as catalyst. Compared to intact catechin, the scavenging activity of the POSS-catechin conjugate against superoxide anion was greatly improved. In addition, the conjugate strongly inhibited xanthine oxidase activity.

Impaired pancreatic endocrine and exocrine responses in growth-retarded piglets.

The alteration of pancreatic endocrine and exocrine secretory responses induced by secretagogues and neural input was investigated in post-weaning growth-retarded (GR) piglets. Blood and pancreatic juice were collected from these animals (6-8-weeks old). Plasma insulin and pancreatic digestive enzymes induced by nutrients, drugs and vagal stimulation were measured biochemically. The pancreas was inspected by immunohistochemical analysis. In GR piglets, the plasma glucose and insulin concentrations at the resting state were very low, and the secretory response was also markedly reduced, with maximum inhibition of 90% by glucose administration and 83% by arginine administration. The insulin secretion was not increased by 2-deoxy-D-glucose administration in GR piglets. The pancreatic juice secretions induced by vagal stimulation and secretagogues in GR piglets were not different from those induced in the control piglets. However, amylase activity in the pancreatic juice and in the pancreas was significantly decreased in GR piglets, although trypsin and chymotrypsin activities were not different. In the immunohistochemical analysis, the numbers of islets and the staining degree for insulin antibody also declined in the pancreases of GR piglets. These results indicated the reduction of insulin and amylase secretions from the pancreas in GR piglets, suggesting that a dysfunction of pancreatic endocrine and exocrine secretion during growth after weaning may be an important factor in the induction of growth retardation in piglets.

High-resolution genetic map of bovine chromosome 29 through focused marker development.

Chromosome-specific libraries aid in the development of genetic maps and focus marker development in areas of the genome with identified quantitative trait loci (QTL). A small-insert BTA29 library constructed by microdissection of a 1:29 Rb-fusion cell line, was screened for dinucleotide repeats (CA)(15) and/or (GA)(15) with the goal of generating new genetic markers for this, the smallest bovine autosome. A total of 90 primer pairs were designed and 82 of these successfully amplified bovine genomic DNA by PCR. In addition to these 82 loci, primer pairs were developed for nine putative genes identified from the sequenced clones by BLAST searches of GenBank. A somatic cell panel was used to test for synteny of the new loci with two previously mapped BTA29 markers located on the MARC bovine linkage map. A total of 75 of the 82 microsatellite (ms) loci were integrated into the MARC bovine linkage map. Linkage analysis placed 69 ms markers on BTA29, five on BTAX and one on BTA1. Combined results of the somatic cell and linkage analyses place 79 new markers (ms and gene-related) on BTA29, six loci on BTAX and two loci on BTA1. The results of this effort significantly increase the marker density on BTA29, expanding the ability to fine map QTL associated with this chromosome.

Calcifying tendonitis of the gastrocnemius. A report of three cases.

We describe the clinical features of calcifying tendonitis in the medial head of gastrocnemius in three elderly female patients. The presenting symptom was chronic pain in the posteromedial area of the knee in two patients and acute pain in the back of the knee in one. All had limitation of movement of the knee and marked tenderness in the region of the tendinous origin of the medial head of gastrocnemius with posterior knee pain induced by stretching the tendon. An injection of 1% lidocaine and steroid into the tendon resulted in temporary relief from pain and improved movement.

Development of 47 new microsatellite markers from a BTA6 library.

Chromosome-specific libraries provide a means to isolate genetic markers from specific chromosomal regions. A small-insert BTA6 library, constructed by microdissection, was screened for dinucleotide repeats (CA)15 and (GA)15. A total of 47 new microsatellite loci were developed and tested for polymorphism and informativeness using the MARC bovine mapping family.

Diffuse intrasinusoidal liver metastasis of small cell lung cancer causing fulminant hepatic failure: CT findings-a case report.

A 65-year-old man with small cell lung cancer treated with two courses of chemotherapy manifested appetite loss and abdominal distention 10 days before admission. Helical CT scanning of the abdomen and pelvis disclosed marked hepatomegaly without any visible nodular lesion in the hepatic parenchyma. He died of severe liver dysfunction with multiorgan failure on the 20th hospital day. Autopsy revealed diffuse invasion of tumor cells into the sinusoid throughout the liver.

[Complete transection of the left main bronchus due to a blunt chest trauma: report of a case].

A 62-year-old man was injured in a traffic accident. A chest roentgenogram showed pneumothorax, hemothorax, subcutaneous and mediastinal emphysema, multiple rib fractures, and a shift of the trachea to the right. Bilateral thorax drainage was performed, and air leakage from a left chest tube was observed. A chest computed tomogram demonstrated stenosis and deformation of the left main bronchus. Bronchofiberscopy revealed complete obstruction of the left main bronchus by the left main pulmonary artery. An emergency thoracotomy revealed complete transection of the left main bronchus and laceration. End-to-end anastomosis of the left main bronchus was performed with interrupted 4-0 PDS II suture. The patient was discharged at the 33rd hospital day.

Effect of combined treatment with radiation and low dose etoposide on cell survival.

BACKGROUND: To improve the radiotherapy results, we evaluated etoposide as an effective radiosensitizer by using cultured cell-lines. MATERIALS AND METHODS: Four cell lines having different doubling times (DT) were used: V79 (Chinese hamster fibroblasts, DT = 9 hours), (1), T24 (human bladder cancer, DT = 19 hours) (2), MDA-MB231 (human breast cancer, DT = 25-30 hours) (3) and RMG1 (human ovarian cancer, DT = 50 hours) (4). Cell survival was determined by colony assay and cell cycle analysis was performed by flow-cytometry. RESULTS: The survival curves showed RMG1 to be the most radiosensitive, followed by MDA-MB231, T24, and V79. V79 was most chemosensitive to etoposide, followed by T24, MDA-MB231 and RMG1. Neither 24-hours exposure to etoposide (< or = 0.05 microgram/ml) or 0.5-h exposure (< or = 1.0 microgram/ml) had any cell killing effect on any of the cell lines used. When the cells were irradiated after exposure to 1 microgram/ml of etoposide for 0.5 hours, no radiosensitization was observed in any of the cell lines except V79. Enhanced radiosensitivity was observed in V79 and T24 cells (which have a relatively short DT) when they were incubated with 0.05 microgram/ml etoposide for 24 hours but no enhanced effect was seen in MDA-MB231 or RMG1 cells (which have a relatively long DT). CONCLUSION: It is suggested that a combination of radiation and etoposide may be useful in the treatment of rapidly growing cancer.

Cell killing and mutation induction by heavy ion beams.

Carbon beam radiotherapy for cancer patients was initiated in Japan in June 1994. This study attempts to clarify the radiobiological effects of heavy ion beams. In this study, human cancer cell lines (RMG-1, MDA-MB231) and V79 cells were used. The cell killing was determined by colony forming assay, and mutation induction was determined by counting the number of 6-thioguanine resistant colonies (hprt locus mutation assay). The cell lines were irradiated with carbon (20 or 80 keV/microm) or neon beams (80 keV/microm). Carbon ions with a higher LET value (80 keV/microm) had an enhanced cytotoxic effect compared to those with a lower LET value (20 keV/microm). Carbon beams produced a slightly stronger cytotoxic effect than neon beams when irradiated at the same LET level (80 keV/microm), but the difference was not remarkable. The mutant fraction was significantly higher in all cell lines when they were irradiated with heavy ion beams, compared to the results for X-ray irradiation. The mutant fraction increased when the LET of the carbon beams increased. At equivalent LET values, the mutant fraction was lower for neon beams than for carbon beams. Fractionation of carbon beam irradiation had no effect on survival, but reduced the mutant fraction. Neon beams might be more appropriate for heavy ion therapy, especially when higher doses are being used. In addition, the fractionation of heavy ion beam administration might be appropriate for reducing the mutant fraction.

Genetic analysis of cataract in Ihara epileptic rat.

We analyzed the mode of inheritance of cataract in the Ihara epileptic rat (IER) by crossing experiments, and mapped cataract-related genes by linkage analysis. Cataract did not develop in the F1 animals, but it developed in both male and female animals of backcross and F2. The occurrence rate of cataract was 48.5% in the backcross progeny and 19.4% in the F2 progeny. Thus, the character was considered to be inherited by the autosomal recessive mode. We found two groups that differed according to the time of onset among the backcross and F2 progeny: an early-onset group (EOG), in which cataracts developed by about 4 months after birth, and a late-onset group (LOG), in which cataracts developed 8 months or more after birth. Linkage analysis indicated the presence of one cataract gene each on Chromosome (Chr) 8 and Chr 15, and the cataract was demonstrated to be governed by more than one gene. The gene on Chr 8 was named Catil, and that on Chr 15. Cati2. Catil was involved in the occurrence of cataract, and the conditions required for cataract to develop were Cati1i/Cati1i or Cati1i/Cati1w. However, in the cataract rats with Cati1i/ Cati1w, the allele of Cati2 was always Cati2i/Cati2i. Cati2 was involved in the timing of onset of the cataract, and the precondition for early onset was Cati2i/Cati2i.