Reductive dehalogenation mediated initiation of aerobic degradation of 2-chloro-4-nitrophenol (2C4NP) by Burkholderia sp. strain SJ98.

Burkholderia sp. strain SJ98 (DSM 23195) was previously isolated and characterized for degradation and co-metabolic transformation of a number nitroaromatic compounds. In the present study, we evaluated its metabolic activity on chlorinated nitroaromatic compounds (CNACs). Results obtained during this study revealed that strain SJ98 can degrade 2-chloro-4-nitrophenol (2C4NP) and utilize it as sole source of carbon, nitrogen, and energy under aerobic conditions. The cells of strain SJ98 removed 2C4NP from the growth medium with sequential release of nearly stoichiometric amounts of chloride and nitrite in culture supernatant. Under aerobic degradation conditions, 2C4NP was transformed into the first intermediate that was identified as p-nitrophenol by high-performance liquid chromatography, LCMS-TOF, and GC-MS analyses. This transformation clearly establishes that the degradation of 2C4NP by strain SJ98 is initiated by "reductive dehalogenation"; an initiation mechanism that has not been previously reported for microbial degradation of CNAC under aerobic conditions.

Patients achieving clearance of HCV with interferon therapy recover from decreased retinol-binding protein 4 levels.

Retinol-binding protein 4 (RBP4) is a recently identified adipokine that is elevated in the blood in several insulin-resistant states. We investigated the association between plasma RBP4 and histological and biochemical characteristics of chronic hepatitis C (CHC), as well as changes in RBP4 levels following interferon therapy. Eighty-one patients with CHC infected with genotype 1 received treatment with peginterferon plus ribavirin. Histological data were available for 41 out of 81 patients before treatment, and the degree of fibrosis, inflammation and steatosis was assessed. Plasma levels of RBP4 were determined in serial samples (before, at the end of treatment, and at 6 months post-treatment). RBP4 levels were lower in CHC patients than in control subjects (34.6 +/- 12.3 microg/mL vs 46.2 +/- 10.5 microg/mL; P

[Synchronous double carcinoma of the left lung and esophagus; report of a case].

A 75-year-old man, who was followed for the atypical epithelium of the stomach, was diagnosed as esophageal carcinoma. Further examination revealed left lung tumor that was suspected of lung carcinoma. Radical operation of the esophageal carcinoma was performed. On 41st postoperative day, after open biopsy for the left lung tumor, left upper lobectomy was performed. Pathological diagnosis was moderately differentiated squamous cell carcinoma of the esophagus and well differentiated adenocarcinoma of the lung. Synchronous double carcinoma of the lung and the esophagus is rare.

Sonographic evaluation for peripheral pulmonary nodules during video-assisted thoracoscopic surgery.

BACKGROUND: The clinical value of sonographic guidance during video-assisted thoracoscopic surgery (VATS) was studied in 26 patients with peripheral pulmonary nodules. METHODS: Twenty-six patients underwent VATS between June 2000 and March 2001 for primary lung cancer (n = 15), pulmonary metastasis (n = 6), and various benign tumors (n = 5). RESULTS: Sonographic guidance successfully visualized peripheral pulmonary tumors in 21 of the 26 patients (81%). Among them, rich intratumoral blood flow signal was identified in 8 of the 15 primary lung cancers by using color Doppler sonography. The peak velocity was 26 +/- 12.8 cm/s in primary lung cancer and 9.4 +/- 1.7 cm/s in pulmonary metastasis, respectively (p <0.01). CONCLUSION: Sonographic guidance during VATS is helpful for locating lesions and determining the extent of surgical resection. The color Doppler method was also useful for evaluating intratumoral blood flow, which yielded significant information for differentiating primary lung cancer, metastatic tumors, and various benign tumors.

[Thoracoscopic surgery for an aged patient with T1N0 non-small cell lung cancer: case report].

An 85-year-old woman was referred to our hospital because of an abnormal shadow in the right upper lung field in chest roentgenograms. CT scans revealed a tumor, 3 cm in diameter at the peripheral field of the upper lobe. The lesion was diagnosed adenocarcinoma of the lung by transbronchial lung biopsy (c-T1N0M0). She underwent a partial resection of he S3 in consideration of age and the clinical stage, by using thoracoscopic procedure. Her postoperative course was uneventful and she was discharged on the 14th postoperative day. Since then, she has been free from recurrence for the past 3 years. Thoracoscopic surgery appears to be useful for aged patients with peripheral early lung cancer because of low incidence of postoperative disability and complications.

[A successful removal of T4 lung cancer with its left atrial extension using cardiopulmonary bypass].

A 42-year-old man presented with cough, chest pain and dyspnea. The chest roentgenogram revealed a large mass shadow in the right upper and middle lobes with atelectasis and pleural effusion. Massive polypoid tumor extending into the left atrium was diagnosed by computed tomography and two dimensional echocardiography. In order to prevent sudden death and cardiac failure, surgery was performed. At first, the polypoid tumor in the left atrium was removed with a partial resection of the left atrial wall under cardiac arrest using cardiopulmonary bypass. Then, a right pneumonectomy was performed. Episodes of embolism were not observed during surgery. His postoperative course was almost favorable. The size of the tumor in the right lung was 18 x 15 x 8 cm and the one in the left atrium was 6.5 x 4.5 x 3 cm, respectively. Pathological examination of the resected specimen revealed the evidences of large cell carcinoma extending into the left atrium. Local recurrence with S9 metastasis of the left lung were detected 6 months after surgery, and he died 6 months later. It is emphasized that the extended surgery using cardiopulmonary bypass was useful for both prevention of embolism and improvement of quality of life.

[Thoracoscopic surgery for pneumothorax with bullous emphysema in an elderly patient: a case report].

Recent advances in optical and endoscopic operating instruments have made thoracoscopic surgery easier. The authors report the case of an 83-year-old patient who was referred to our hospital for right spontaneous pneumothorax associated with severe bullous emphysema. Chest X-ray films showed 40% collapse of right lung and the right spontaneous pneumothorax was treated by chest tube drainage for 3 weeks. However air leak was not decreased and subcutaneous emphysema appeared. Chest computerized tomography revealed multiple bullae. Thoracoscopic surgery was performed because of preservation of the respiratory function. The ruptured bulla was resected by using ENDO GIA and the other multiple bullae were resected similarly in order to improve the pulmonary function. A surgical drain was removed on the 14th postoperative day because of a little air leak continuing. His postoperative course was uneventful after removal of the chest drain. He was discharged on 27th postoperative day and had no shortness of breath in daily life. From our experience, thoracoscopic surgery appears to be much better than thoracotomy for spontaneous pneumothorax because of much less postoperative disability and preservation of respiratory function.

Mechanism of Phreatic Eruptions at Aso Volcano Inferred from Near-Field Broadband Seismic Observations

Broadband seismometers deployed at Aso volcano in Japan have detected a hydrothermal reservoir 1 to 1.5 kilometers beneath the crater that is continually resonating with periods as long as 15 seconds. When phreatic eruptions are observed, broadband seismograms elucidate a dynamic interplay between the reservoir and discharging flow along the conduit: gradual pressurization and long-period (approximately20 seconds) pulsations of the reservoir during the 100 to 200 seconds before the initiation of the discharge, followed by gradual deflation of the reservoir concurrent with the discharging flow. The hydrothermal reservoir, where water and heat from the deeper magma chamber probably interact, appears to help control the surface activity at Aso volcano.

[Extracorporeal circulation for removal of carcinoma of the lung invading the left atrium].

A 42-year-old man with one year history of cough and chest pain due to right upper lung cancer was scheduled for radical surgery. An echocardiogram and a lung scan showed a tumor mass in the left atrium, which was originating from carcinoma of the right upper lobe. Right pneumonectomy and atrial tumor extirpation were done successfully under the state of cardiac arrest using extracorporeal circulation with topical cooling by crushed ice in order not to spread the tumor cells into systemic circulation. He was extubated on the 1st postoperative day. But, thereafter he developed moderate dyspnea. On 7, 10 and 13th postoperative days he fell into the state of CO2 narcosis. Decreased capacity of the lung after the pneumonectomy and left phrenic nerve injury during the operation were considered factors causing the respiratory insufficiency. Patient was discharged 6 weeks later and continued to have consultations at the outpatient clinic.

[A case of primary cryptococcosis of the lung].

A 37-year-old man was pointed out having an abnormal shadow in the right lung field at a medical checkup in July 1992. There was 5-year life history of rearing about 60 macaws since 10 years before. Upon operation a tumor 1.5 cm in diameter was palpated in the right S6. Intraoperative frozen section diagnosis revealed no malignancy. Partial excision was performed. The excised specimen showed a 1.5 x 1.4 x 1.0 cm, well-defined and yellowish white tumor. Histologically it was granuloma with a thin fibrous capsula, and most of the granuloma necrotized involving cryptococcus formans. Postoperative serum cryptococcus antigen and antibody titers were negative. There has been no sign of recurrence, as of 8 months after the operation. No adjuvant chemotherapy has been needed.

[A case of human growth hormone (h-GH)-producing adenocarcinoma of the lung].

The authors reported a case of a 56-year-old man with lung cancer which secreted human growth hormone (hGH). On admission, he had clubbed fingers and gonalgia without complaining cough or sputum. Serological examination revealed a high level of hGH which was 22.7 ng/ml (normal < 1.46). Right upper lobectomy was performed in February, 1994. It returned to the normal level after resection of the tumor. Gonalgia was improved but he still had clubbed fingers after operation. Histological examination of the tumor shows poorly differentiated adenocarcinoma with no evidence of lymph node metastasis. Immunohistochemical study showed that a group of the tumor cells demonstrated a specific reaction for anti-hGH antibody.

[A case of unusual shaped pulmonary arteriovenous fistula].

Autopsy findings of pulmonary arteriovenous fistula (PAVF) was initially described by Churton in 1897. Since then, several hundreds of cases have been reported in Europe and the United States. In Japan, there has recently been an increase in case reports of PAVF. PAVF seems to be no longer a rare disorder in Japan. Several morphological classifications of PAVF have been reported. One of these classifies PAVF into 1) solitary types 2) multiple types and 3) diffuse telangiectasia. Another, for example, classifies the disorder into the following 3 types: 1) multiple telangiectasia 2) pulmonary arterial aneurysm and 3) pulmonary artery-left atrial communications. Many other classifications have been proposed. In the solitary type (PA aneurysmal type), fistulas are located at the relatively large, central vessels. Here we report a case of PAVF which presented not as a solitary aneurysm but rather as a distended and tortuous anomalous vessel.

[A case of Rendu-Osler-Weber disease associated with pulmonary arteriovenous fistula].

A 60-year-old female was admitted with a chief complaint of left hemothorax. Chest X-ray films revealed an abnormal shadow when the pleural effusion disappeared. On the physical examination, multiple telangiectases were found at the nasal mucosa, tongue and stomach. The family history showed that her son experienced frequent episodes of epistaxis. The patient was diagnosed to have Rendu-Osler-Weber disease. CT scanning and pulmonary angiography showed an arteriovenous fistula of the left lower lobe (S10) and cerebral angiography did a small arteriovenous fistula in the cerebellum. Pulmonary partial resection was performed to prevent re-hemorrhage. Pulmonary arteriovenous fistula was 2.5 x 1.5 cm in size. It located in the left lower lobe exposing through the surface of the lung over the diaphragm. The postoperative course was uneventful and she was discharged on the 18th postoperative day without any complications.

[Descending thoracic aorto-aortic bypass grafting for coarctation of the aorta in an adult combined with a cerebral arterial aneurysm--a case report].

Coarctation of the aorta (CoA) in adults is often accompanied by hypertension, but CoA combined with a cerebral arterial aneurysm is rare. We performed successfully descending thoracic aorto-aortic bypass grafting for CoA in an adult who had a cerebral bleeding and a cerebral arterial aneurysm. The patient was a 46-year-old female who had the history of hypertension. She suddenly suffered from left hemiparesis due to cerebral bleeding, then a left middle cerebral arterial aneurysm and CoA were detected at the same time. Aortography showed that the internal diameter of the portion of the coarctation was 2.8 mm and the poststenotic dilatation was prominent. The peak systolic pressure gradient across the coarctation was 60 mmHg. We took the precedence of the surgical repair for CoA over that for the cerebral arterial aneurysm, because her cerebral arterial aneurysm was judged to have less risk to rupture from the viewpoint of its size and shape by neurosurgeons. We performed proximal descending thoracic aorto-distal descending thoracic aortic bypass grafting with a woven double velour graft of 16 mm in internal diameter and 9.5 cm in length. Intraoperative cerebrovascular hypertension can be avoided by this procedure. Furthermore the peak systolic pressure gradient has disappeared immediately after grafting. In general, the coarctectomy with direct end-to-end anastomosis is prevalent for CoA in adults. On the other hand, the descending thoracic aorto-aortic bypass grafting for CoA in adults has rarely been reported.(ABSTRACT TRUNCATED AT 250 WORDS)

[Experience of double internal thoracic artery grafts in coronary artery revascularization].

We have started employing two internal thoracic artery grafts in coronary artery revascularization since February 1988. We have carried out seven such operative procedures in a 15 month period since then. Ages ranged from 55 to 67 years with a mean of 60.6. Six patients were male and one patient was female. One patient was in Canadian Cardiovascular Society angina Class I, one in Class II, four in Class III, and one in Class IV, preoperatively. There were no operative deaths. Postoperatively, six patients were in CCS Class I and one was in Class II. All of the internal thoracic artery grafts were patent at hospital discharge in six angiographically examined patients. We feel that use of double internal thoracic artery grafts in coronary revascularization carries minimal additional risk, when performed in selected case.