Prospective study of deep vein thrombosis in patients with spinal cord injury not receiving anticoagulant therapy.

STUDY DESIGN: Prospective cross-sectional study. OBJECTIVES: To investigate the timing of deep vein thrombosis (DVT) onset secondary to spinal cord injury without anticoagulant therapies. SETTING: Spinal Cord Injury Center in Hokkaido, Japan. METHODS: Between November 2012 and June 2013, patients with spinal cord injury who were admitted to our hospital within 1 day after the injury and treated surgically within 24 h underwent a neurological examination, leg vein ultrasonography and D-dimer test 1, 3, 7, 14 and 28 days after surgery. All patients received treatment with intermittent pneumatic compression and elastic stockings, but without any anticoagulant. RESULTS: DVT developed in 12 patients (11 men and 1 women), with a mean age of 62.2 years (range, 41-80 years; mean age of total sample, 63.2 years (range, 25-78 years)), all distal to the popliteal vein. DVT occurred more often with a more severe paralysis (66.3%, AIS A and B). The median (± standard error) length of time from the operation to DVT detection was 7.5±2.2 days. The mean D-dimer level upon DVT detection was 14.6±11.8 µg ml(-1), with no significant differences between those who developed DVT and those who did not at any of the time points. CONCLUSION: These results suggest that DVT can develop at the very-acute stage of spinal cord injury and the incidence increases with a more severe paralysis. DVT detection was more reliable with ultrasonography, which should be used with DVT-preventive measures, beginning immediately after the injury, for the management of patients with spinal cord injury.

Gypsum and organic matter distribution in a mixed construction and demolition waste sorting process and their possible removal from outputs.

With insufficient source separation, construction and demolition (C&D) waste becomes a mixed material that is difficult to recycle. Treatment of mixed C&D waste generates residue that contains gypsum and organic matter and poses a risk of H(2)S formation in landfills. Therefore, removing gypsum and organic matter from the residue is vital. This study investigated the distribution of gypsum and organic matter in a sorting process. Heavy liquid separation was used to determine the density ranges in which gypsum and organic matter were most concentrated. The fine residue that was separated before shredding accounted for 27.9% of the waste mass and contained the greatest quantity of gypsum; therefore, most of the gypsum (52.4%) was distributed in this fraction. When this fine fraction was subjected to heavy liquid separation, 93% of the gypsum was concentrated in the density range of 1.59-2.28, which contained 24% of the total waste mass. Therefore, removing this density range after segregating fine particles should reduce the amount of gypsum sent to landfills. Organic matter tends to float as density increases; nevertheless, separation at 1.0 density could be more efficient.

Evaluation of silica gel-immobilized phosphorylcholine columns for size exclusion chromatography and their application in the analysis of the subunit structures of fish-egg lectins.

Columns of phosphorylcholine (PC) immobilized on silica gel were shown to be useful for size exclusion chromatography (SEC) of proteins. The columns provided good separation of proteins in 50mM sodium phosphate buffer (pH 6.9) containing 0.25 M NaCl, and there was a linear relationship between the retention times and the logarithmic values of the molecular weights with a correlation coefficient (R(2)) of 0.978-0.992. The columns were used in analyzing the subunit structures of the rhamnose-binding lectins CSL1, CSL2, and CSL3, isolated from chum salmon (Oncorhynchus keta) eggs. Although the lectins, which are a group of carbohydrate-binding and hydrophobic proteins, behaved anomalously in SEC with conventional matrices, they could be eluted from the immobilized PC columns without non-size-related retention, thereby allowing their molecular weights to be reliably estimated.

Characterization of residual carbon influencing on de novo synthesis of PCDD/Fs in MSWI fly ash.

Using 19 samples of fly ash collected from various MSW incineration facilities, residual carbon was characterized by gasifiable fraction at 450 degrees C (C450), and the correlations with de novo synthesis of PCDD/Fs were experimentally examined. Fly ashes were classified into three groups by the ratio of C450 to total residual carbon. By comparison of CO and CO2 generation patterns with those of reference materials, unburnt carbon of solid waste and activated carbon powder injected into flue gas were identified as a carbon source in fly ash. In the experiment of de novo synthesis of PCDD/Fs, the content of PCDD/F synthesis depended on C450 regardless of the origin of carbon. In addition, the model to predict the content of PCDD/F synthesis, DeltaPCDD/F=0.989.Cu.C450, fitted well with experimental values.

Recovery of zinc and lead from fly ash from ash-melting and gasification-melting processes of MSW--comparison and applicability of chemical leaching methods.

Fly ash generated from MSW ash-melting and gasification-melting plants, known as Melting Furnace Fly Ash (MFA), contains considerable amounts of heavy metals such as Pb and Zn. These metals can be recovered using a smelting furnace after "pre-treatment" for removal of unnecessary elements such as Cl, Sn and Si. Chemical methods have been studied for pretreatment in the past. However, they have been discussed only with regard to treatment cost and the concentration of Pb and Zn recovered, but neither applicability to various types of MFA nor the environmental impact have been considered. In this study, acid, alkaline and ammonia/chloride leaching methods were compared from the standpoints of: (1) applicability to MFA, (2) concentration of Pb and Zn recovered, (3) treatment cost, and (4) environmental impact. Twenty-three samples of MFAs were collected and classified into 4 types based on element contents. A Pb and Zn recovery experiment was conducted for the representative MFA of those types. The results showed: (1) MFA from gasification-melting plants cannot be treated by chemical methods; (2) the other MFA can be treated to an acceptable quality by existing smelting furnaces; (3) only MFA from electric resistance ash-melting plants can be treated easily by the water washing method; and (4) alkaline and ammonia/chloride leaching methods were more effective than acid leaching.

Elevation of cytokeratin 19 fragment (CYFRA 21-1) in serum of patients with radiation pneumonitis: possible marker of epithelial cell damage.

Cytokeratin 19 fragment (CYFRA 21-1) level in serum have already been documented as a useful tumor marker for lung cancer. In the present study, we hypothesized that CYFRA 21-1 increases in the sera of patients with radiation pneumonitis, resulting from epithelial cell damage. We measured CYFRA 21-1 in the sera of patients with radiation pneumonitis and evaluated the correlation between CYFRA 21-1 level and severity of radiation pneumonitis as well as clinical course. We studied 16 patients diagnosed with radiation pneumonitis associated with primary lung cancer. CYFRA 21-1 levels in the sera of patients with diffuse radiation pneumonitis (n = 6) significantly increased compared to normal smokers (n = 10) or patients with local radiation pneumonitis (n = 10). CYFRA 21-1 values in sera changed according to the progression or improvement of the diffuse radiation pneumonitis. An immunohistochemical study using pulmonary tissues obtained from autopsied patients with radiation pneumonitis demonstrated that the hyaline membrane and proliferating type II pneumocytes were strongly stained by the anti-human cytokeratin 19 antibody. Our data demonstrated that CYFRA 21-1 was increased in patients with diffuse radiation pneumonitis. Since CYFRA 21-1 is widely used as a tumor marker for lung cancer, this evidence should be noted especially in irradiated patients.

Expression of thyroid transcription factor-1 in 16 human lung cancer cell lines.

It has been suggested that thyroid transcription factor-1 (TTF-1) is frequently expressed in human lung cancer, especially in adenocarcinoma and small cell lung cancer, and the TTF-1 expression is closely related with the expression of surfactant protein. We hypothesized that TTF-1 is expressed in human lung cancer cell lines and its expression might be related to the expression of surfactant protein. To test this, expressions of TTF-1 and surfactant protein A (SP-A) were immunohistochemically evaluated in 16 human lung cancer cell lines. In addition, expressions of mRNAs for TTF-1 and SP-A were analyzed by reverse transcriptase-polymerase chain reaction (RT-PCR) and sequencing. As a result, nuclear staining of TTF-1 was observed in two of six adenocarcinoma cell lines, none of seven small cell lung cancer cell lines, and none of three squamous lung cancer cell lines. Among the 16 cell lines, six cell lines (PC3, LC2/Ad, A549, RERF-LC-OK, HI1017, and PC9) expressed significant amounts of mRNA for TTF-1. In contrast, cytoplasmic staining of TTF-1 was observed in five of six adenocarcinoma cell lines, in six of seven small cell lung cancer cell lines, and in all three squamous cell lung cancer cell lines. One of the two adenocarcinoma cell lines those showed positive nuclear staining and cytoplasmic SP-A staining released a significant amount of SP-A in culture supernatant. Our present study demonstrates that the frequency of TTF-1 expression in the nucleus was very low in human lung cancer cell lines; however, their cytoplasmic positivities should be further investigated.

Pulmonary stenosis in recipient twins in twin-to-twin transfusion syndrome: report on 3 cases and review of literature.

This report describes 3 cases of pulmonary stenosis in the recipient twin in twin-twin transfusion syndrome. Fetal echocardiography showed cardiomegaly, tricuspid valve regurgitation, and increased reverse flow in the inferior vena cava, as signs of congestive heart failure in all 3 cases. We diagnosed 2 cases of pulmonary stenosis by fetal echocardiography prenatally and confirmed our findings in all 3 cases postnatally. Two cases underwent postnatal balloon valvuloplasty to release the pulmonary valvular stenosis in neonatal period. The third one died soon after delivery and autopsy showed a slightly thickened pulmonary valve. One of the cases was diagnosed in the early second trimester (20 weeks of pregnancy), the earliest detection of fetal pulmonary stenosis reported in literature. The presence of high peak velocity of the pulmonary artery at 20 weeks of pregnancy preceded the development of pulmonary stenosis in this case. This supports the hypothesis that alterations in fetal hemodynamics may result in structural cardiac abnormality.

Effects of progestins on the metabolism of cancellous bone in aged oophorectomized rats.

The effects of progestins on bone loss in female oophorectomized (ovx) rats were evaluated. One-year-old Sprague-Dawley rats were divided into eight groups: (1) beginning controls (control); (2) sham-operated controls (sham); (3) ovx; (4) ovx treated with estrogen (ovx + E); (5) ovx treated with progesterone (ovx + P); (6) ovx treated with estrogen and progesterone (ovx + E + P); (7) sham group treated with estrogen (sham + E); and (8) sham group treated with progesterone (sham + P). Immediately after surgery, the rats in the hormone injected groups were subcutaneously (s.c.) injected daily for 15 weeks with estrogen (17-beta-estradiol, 0.01 mg/kg in ethanol), or progesterone (4-pregnene-3,20-dione, 0.1 mg/kg in ethanol), or both. At the end of 15 weeks, the bone mineral density (BMD) and bone histomorphometry of the rats' lumbar vertebrae and serological parameters were measured. In the sham, ovx, and ovx + P groups, treatment with progesterone alone did not maintain the BMD in the lumbar vertebrae, but in the ovx + E and ovx + E + P, sham + E, and sham + P groups, progesterone did not inhibit the action of estrogen in the aged ovx rat model. BMD in the sham + P group was significantly higher than in the sham group (270.8+/-10.8 mg/cm2 versus 253.6+/-10.2 mg/cm2; p < 0.01). Bone histomorphometry revealed that bone volume (BV/TV) increased more in the ovx + E + P group than in the ovx + E group and more in the sham + P group than in the sham group, but not significantly. The ovx + E, ovx + E + P, sham + E, and sham + P groups showed no significant differences in the bone formation and resorption parameters, but the bone formation variables tended to increase in the ovx + E + P and sham + P groups. We concluded that progesterone alone cannot prevent bone loss or the increase in turnover after ovx and that estrogen, not progesterone, accounted for all of the bone activity in this study. It seems doubtful that progesterone inhibits the action of estrogen, and in fact may have a beneficial effect on bone metabolism.

Bone structural and metabolic changes at the end of pregnancy and lactation in rats.

OBJECTIVE: The objective of this study was to elucidate the net change of bone structure and metabolism in the lumbar trabecular bone of rats at the end of the pregnancy and lactation. STUDY DESIGN: Female virgin Sprague-Dawley rats aged 200 days were mated, and bone mineral density by dual-energy x-ray absorptiometry, bone histomorphometry, and serum bone metabolic markers were measured at the end of pregnancy (day 22 of pregnancy), after delivery (day 5 post partum), and at the end of lactation (day 21 post partum). RESULTS: At the end of pregnancy bone mineral density, bone volume, trabecular thickness, and serum calcium decreased; serum parathyroid hormone increased; and the histomorphometric parameters indicated that bone resorption were higher than those variables in nonpregnant rats, but bone formation was suppressed, as demonstrated by the low histomorphometric parameters and by the low serum alkaline phosphatase levels. After delivery the bone mineral density of nonlactating rats recovered rapidly, as in nonpregnant rats, but nonlactating rats showed more bone formation by histomorphometry than nonpregnant rats did. At the end of lactation, bone mineral density and serum calcium levels decreased considerably, and lactating rats showed substantial bone formation, bone resorption, and high serum alkaline phosphatase levels. The correlation between the number of pups (x) of the lactating and nonlactating groups and the bone mineral density (y, in grams per square centimeter) showed simple linear regression (y = -0.0067 . x +0.2517, r = 0.949, p < 0.0001). CONCLUSIONS: These results indicate that significant decreases occur in the trabecular bone of rats at the end of pregnancy and lactation and that lactational intensity is related to bone mineral density.

[A case of Sjögren's syndrome complicated by membranous nephropathy].

A case of Sjögren's syndrome (SjS) complicated by membranous nephropathy (MN) is presented. A 50-year-old female was admitted to Toho University Hospital because of overt proteinuria (5g/day). She had xerotic keratitis in addition to a renal disorder, and laboratory data showed positive anti-nuclear antibody (ANA) and anti-SSA antibody. The specimens from renal biopsy revealed mild thickening of the glomerular basement membrane under light microscopy, positive IgG along the capillary walls revealed by immunofluorescence, and sparse and irregular subepithelial electron dense deposits seen under electron microscopy. No interstitial changes were observed. From these findings, she was diagnosed as having SjS complicated by MN. Proteinuria gradually decreased with a reduction in serum levels of ANA and anti-SSA antibody following corticosteroid therapy. Although renal interstitial lesions occasionally develop in patients with SjS, glomerular changes, especially MN, are very rare. We suspect that immunocomplexes, such as anti-SSA antibody, revealed in SjS patients could be responsible for the glomerular lesions, leading to MN.

Physiological dose of estrogen regulates extrathymic T cells in female mice.

Bilateral ovariectomy was performed in female C57BL/6 mice to investigate whether extrathymic T cells in the liver are regulated by physiological doses of estrogen or progesterone. Extrathymic T cells were identified using a two-color immunofluorescence test for CD3 and interleukin-2 receptor beta-chain (IL-2R beta) antigens. The T cells were identified as intermediate CD3+ cells with a high expression of IL-2R beta. It was further demonstrated that the proportion and number of intermediate CD3+ cells decreased in response to ovariectomy, an effect that was countered by estrogen administration. These results suggest that the activation of extrathymic T cells may be regulated by physiological levels of estrogen.

Oral administration of recombinant human erythropoietin in liposomes in rats: influence of lipid composition and size of liposomes on bioavailability.

Intestinal absorption of recombinant human erythropoietin (Epo) encapsulated in liposomes (Epo/liposomes) was examined by measuring the pharmacological effects of Epo after oral administration in rats. Circulating reticulocyte counts after oral administration of Epo/liposomes showed a profile different from that after intravenous administration. Epo/liposomes 0.1 micron in diameter were absorbed more effectively than those 0.2 micron in diameter. In the 0.1 micron Epo/liposomes composed of dipalmitoylphosphatidylcholine (DPPC) and soybean-derived sterols (SS), cholesterol (Ch), or soybean-derived sterylglucosides (SG), DPPC/SS (in molar ratio 7/2) and DPPC/Ch (7/2) showed higher efficiency in intestinal absorption than DPPC/Ch (7/4) and DPPC/SG (7/2) at a low dose by the sysmex method. Pharmacological availabilities for oral administration of Epo/liposomes were 0.74-31% and 3.3-30% as evaluated by circulating reticulocyte counts and percentage circulating reticulocytes of erythrocytes, respectively, in comparison to those for intravenous administration of the same dose.

[The significance of bone mineral density measurement of premenopausal women].

We examined the starting age for measuring bone mineral density (BMD) in premenopausal women to detect osteopenia as soon as possible. BMD of the second to fourth lumbar spine vertebrae was measured by dual-energy X-ray absorptiometry to determine normal values for 500 healthy premenopausal women (aged from 17 to 55). We found the rate for low BMD premenopausal women, whose BMD was under the peak bone mass-2SD. And we compared normal BMD women with low BMD women with reference to menstrual history, obstetrical history, and life style, by means of a questionnaire. The peak bone mass of premenopausal women was reached between 35 and 39 years of age (1.059 +/- 0.097g/cm2). The low BMD rate was 7% in all premenopausal women, and increased to 13.5% at from 45 to 49 years. On the other hand, it was only from 5.7 to 7.4% even at from 20 to 29 years. There was the positive correlation between BMD and the body mass index (BMI). There was no statistically significant difference between the low BMD women and the normal BMD women in menstrual history, obstetrical history or life style (parity was 1.7 +/- 1.6 and 1.1 +/- 1.2, respectively, p < 0.05). We concluded that premenopausal women should have their BMD measured after aged 45, and be measured once from 20 to 40 years of age if possible.

Effects of progesterone on the metabolism of cancellous bone in young oophorectomized rats.

The effects of progesterone on cancellous bone in young rats were evaluated. Fifty female rats aged 90 days were divided into 5 groups: (1) Sham-operated controls (SHAM); (2) oophorectomized (OVX) rats; (3) OVX rats treated with estrogen (OVX+E); 4) OVX rats treated with progesterone (OVX+P); and (5) OVX rats treated with estrogen and progesterone (OVX+EP). After surgery, some animals were treated subcutaneously (s.c.) with 0.5 mg of estradiol dipropionate depot, with 5 mg of hydroxyprogesterone capronate depot, or with both hormones, at intervals of 7 days. After 180 days, the bone mineral density (BMD) and bone histomorphometry of their lumbar vertebrae and serological parameters were measured. In the OVX+P group, the BMD and the bone volume as shown by bone histomorphometry were slightly higher than in the OVX group, but not significantly. These parameters in the OVX+E and OVX+EP groups were significantly higher than in the OVX group. The OVX+P group showed a significant increase in the labeled surface and a decrease of the osteoclast number, compared to the OVX group. The OVX+P group showed increases of serum alkarine phosphatase and osteocalcin. From these results, it can be concluded that progesterone treatment might intensify bone formation and suppress bone resorption on cancellous bone in oophorectomized rats, although progesterone alone does not have a positive effect on BMD and bone volume.

[Assessment of osteoporosis in the local population by means of a portable dual energy X-ray absorptiometry unit].

We assessed bone mineral density (BMD) in the local population by means of a portable dual energy X-ray absorptiometry (DXA) unit. BMD was measured by DXA in 197 women (62 premenopausal and 135 postmenopausal) in Shiunji town. Age, height, weight, body mass index (BMI), menstrual history, obstetric history, habits, symptoms and hormonal cytology (eosinophilic index (EI), karyopyknotic index (KPI) and maturation value (MV)) were investigated. A negative correlation (r = -0.645, p < 0.01) was found between BMD and age. Low BMD (BMD < 0.8g/cm2) was found at a rate of 3.2% in premenopausal women and 51.1% in postmenopausal women. The low BMD group of postmenopausal women had significantly lower BMI and higher age at first delivery than the normal BMD group (BMD > or = 0.8g/cm2). There were no differences between the 2 groups in other factors. We found a positive correlation between BMD and hormonal cytology (KPI and MV). These findings suggest that the rate of osteopenia in postmenopausal women is high than expectation and it is difficult to predict bone loss by symptoms, history and habits. The portable DXA unit is useful for screening osteopenia in local populations.

[Neuroexcitotoxic action of db-cAMP: lesioning of neuronal cell bodies while sparing fibers of passage].

In our previous study, we have demonstrated that intra-amygdaloid injection of dibutyryl-cAMP causes neuronal damage in the injected AM and the CA 1-3 subfields of the ipsilateral hippocampus in addition to epileptic seizures. This result suggested that db-cAMP is a new neuroexcitotoxin. In this study, we examined comparative morphological effect on acetylcholinesterase (AChE) following intra-amygdaloid injection of db-cAMP or, kainate. In Expt. 1, twenty rats received 100 micrograms db-cAMP (N = 10), 0.5 micrograms kainate (N = 4), or saline as a vehicle (N = 6), through the implanted cannula under non-anesthesia. Either kainate or db-cAMP produced epileptic seizures, while saline induced no electroclinical ictal response. Following db-cAMP or kainate injection, neuronal loss was observed in the injected AM, but AChE positive fibers were intact. In the hippocampus ipsilateral to the injected AM, the loss of pyramidal cells was also noted in accordance with the severity of seizure intensity. In the piriform cortex ipsilateral to the injected AM, the loss of AChE-positive fibers were seen, but sparing neuronal cell bodies. In Expt. 2, nineteen rats were injected with 100 micrograms db-cAMP (N = 7), 0.5 micrograms kainate (N = 7), or saline as a vehicle (N = 5) under pentobarbital anesthesia. Kainate or db-cAMP produced few sporadic spikes.(ABSTRACT TRUNCATED AT 250 WORDS)

[Change of C19-21 steroids levels of maternal serum, amnion and cord plasma by high pressure liquid chromatography (HPLC) (author's transl)].

With normal pregnant and abnormal pregnant cases as the subjects steroids in the maternal serum at term and plasma cord were measured by HPLC and the following results were obtained. 1) The blood at term proved to contain cortisol 165.06 +/- 38.90 ng/ml, cortisone 85.97 +/- 16.40 ng/ml, progesterone 23.42 +/- 8.77 ng/ml and the blood at delivery to contain cortisol 574.68 +/- 156.76 ng/ml, cortisone 100.94 +/- 27.54 ng/ml and progesterone 41.14 +/- 18.31 ng/ml. Amnion contained cortisol 69.40 +/- 16.72 ng/ml, cortisone 26.11 +/- 9.13 ng/ml, progesterone 29.36 +/- 9.35 ng/ml, cord plasma contained cortisol 109.64 +/- 27.41 ng/ml, cortisone 373.32 +/- 88.60 ng/ml and progesterone 450.53 +/- 113.84 mg/ml. 2) The blood at delivery compared to that term showed especially higher lever of cortisol. Maternal serum showed the pattern of cortisol superiority of the corticoid, while cord plasma showed the pattern of cortisone superiority. 3) Significant correlation was observed between amnion and cord plasma in the gestagen and between amnion and maternal serum-cord plasma in corticoid. 4) In severe toxemia of pregnancy and pregnancy with diabetes mellitus some steroids showed significant low levels as compared to normal case. 5) In severe toxemia of pregnancy cortisone/cortisol ratio was irregular as compared to normal case.