High resolution, low hν photoelectron spectroscopy with the use of a microwave excited rare gas lamp and ionic crystal filters.

The need for not only bulk sensitive but also extremely high resolution photoelectron spectroscopy for studying detailed electronic structures of strongly correlated electron systems is growing rapidly. Moreover, easy access to such a capability in one's own laboratory is desirable. Demonstrated here is the performance of a microwave excited rare gas (Xe, Kr, and Ar) lamp combined with ionic crystal filters (sapphire, CaF(2), and LiF), which can supply three strong lines near the photon energy of hnyu hν=8.4, 10.0, and 11.6 eV, with the hν resolution of better than 600 µeV for photoelectron spectroscopy. Its performance is demonstrated on some materials by means of both angle-integrated and angle-resolved measurements.

Injuries in elite motorcycle racing in Japan.

OBJECTIVES: To investigate the incidence and pattern of injuries, relative risks, and factors affecting incidence among elite motorcycle competitors in Japan. METHODS: A total of 117 elite motorcycle competitors including 36 road racers, 60 motocross racers, and 21 trial bike riders completed a questionnaire about injuries. RESULTS: Sixty major injuries (25 in road racing, 32 in motocross, and three in trial bike riding) were reported. The most common injuries were fractures (45), followed by ligament injuries (8), dislocations (5), and soft tissue injuries (2). The overall injury rate was 22.4 per 1000 hours, and the death rate was zero. There was no significant correlation between risk of injury and age, experience, or accumulated competition points. CONCLUSIONS: Injury rates in competitions such as road racing and motocross are high, and therefore additional safety measures are needed to protect competitors from injury.

[Preoperative autologous blood donation in coronary artery bypass grafting in elderly patients].

Allogeneic blood transfusion still carries risks of transfusion reaction and infection. We examined the effect of a preoperative autologous blood donation (800-1,200 g) by subcutaneous epoetin alpha injection on a series of patients undergoing elective coronary artery bypass grafting (CABG). CABG was being performed with increased frequency in elderly patients. We have performed CABG in 18 patients over 65 years of age (elderly group). These patients were compared with 20 patients under 64 years of age (younger group). Postoperative bleeding and allogeneic blood transfusion were significantly larger in quantity in the elderly group than the younger group (p < 0.05). The incidence of allogeneic blood usage was significantly higher in the elderly group than the younger group (p < 0.05). Therefore, a preoperative autologous blood donation in CABG was considered to be not so effective for saving allogeneic blood transfusion and preventing transfusion reaction or infection in elderly patients.

Prevention of small black spots on sugar-coated tablets containing aluminum acetylsalicylic acid.

Sugar-coated tablets containing aluminum acetylsalicylate gradually developed black spots on their surface. A factorial experiment was performed based on an L32 orthogonal array table in an attempt to halt this phenomenon. The factor responsible proved to be talc used to formulate the smooth coating layer over the subcoating layer containing aluminum acetylsalicylate. When HCl-treated talc was used as a filler for the smoothing layer, the black spots were markedly decreased. The spotting mechanism was considered to be due to hydrolysis of aluminum acetylsalicylate in the subcoating layer to salicylic acid and acetic acid, which sublimated into the pores of the smoothing layer. Then, ferrous ion substituted from magnesium ion in the talc molecule center was extracted by salicylic acid, acetic acid, and moisture. Finally, the ferrous ion was oxidized to ferric ion, and this produced an Fe3+ chelate compound together with salicylic acid.

On preventing sugar-coated tablets from browning.

The phenomenon of browning occurs gradually in the white sugar-coating layer (comprised of sucrose, talc, and powdered acacia) when the coating is applied on a large scale. We found that this phenomenon is negligible on sugar-coated tablets when they are prepared on a small scale. The smoothing layer prepared on a small scale is nearly as opaque as the subcoating layer. Conversely, the smoothing layer produced on a larger scale is semitransparent. In large-scale operations, the conditions required to make the smoothing layer opaque were established, and it was demonstrated that this method can restrict the browning phenomenon. It is considered that the nitrogen-containing contaminants in powdered acacia may react with heat-inverted sucrose (the Maillard reaction) to make brown substances in the smoothing layer and that the opaque appearance of the layer conceals the color accumulation of the brown substances in the smoothing layer and therefore restricts the browning phenomenon.

[Postoperative mediastinitis after the coronary artery bypass grafting using internal thoracic artery graft].

It has been pointed out in general that the resistance against infection is decreased in the diabetic patients. This problem is very important in patients undergoing major surgery. In cardiovascular surgery, the median wound infection may result in life threatening sequelae. We have used the internal thoracic artery as the appropriate graft for its excellent long-term patency. In this series of the diabetic patients who underwent coronary artery bypass grafting with bilateral internal thoracic artery grafts, the incidence of postoperative mediastinitis was significantly higher than other cases. Therefore the use of bilateral internal thoracic artery grafts should be avoided, if possible in the diabetic patients.

[The long-term anterior chest median wound keloid after the cardiac surgery].

We discussed on the long-term anterior chest median wound keloid after the cardiac surgery by using a questionnaire. The risk of the anterior chest median wound keloid was high significantly in the cases using the bilateral internal thoracic artery compared with the cases using no internal thoracic artery. Participation of the decreased blood supply was highly suggested as the cause of this keloid formation.

A new system to detect native microaggregates of platelets in vivo, with a novel platelet aggregometer employing laser light scattering.

Circulating platelets are susceptible to various stimuli in vessels, and a certain portion of platelets may thereby form native microaggregates (NMAs), which can be visualized by a bother scanning electron microscopy (SEM). We developed an easy method to evaluate the existence and extent of NMAs and the subsequent spontaneous platelet aggregation (SPA) induced by not any agonist but stirring force with a novel platelet aggregometer (PA-200; Kowa, Tsukuba, Japan) employing a particle-counting method based on laser light scattering. In this system, platelet-rich plasma obtained by a delicate centrifugation was infused in a cuvette to replace the content and to avoid stirring shear. An insertion attachment was designed in a coaxial shape to maintain a constant sample volume. Our data indicated that NMAs, tentatively defined as a "small" division by their light scattering (25-400 of the intensity threshold), could be detected by not only a complicated SEM but also by our simple system with the PA-200 in a few minutes. No correlation was found in the comparison of the existence of NMAs and the SPA generation, in aliquot platelets, respectively. These results suggested that NMAs and SPA might be mutually different cluster and have meanings as representations of platelet status.

[Coronary artery bypass grafting performed by the simple and convenient graft supporter].

We have experienced a simple, safe and convenient technique for supporting the arterial or saphenous vein graft in the coronary artery bypass grafting. This graft supporter is made of cotton cloth with a 50 percent polyester mix. The supporter is twenty centimeters long and two centimeters wide. This supporter provides the complete fixation of the graft without the holding by the co-operater. Therefore the supporter allows very easy, safe and accurate graft anastomosis with the native coronary artery or the ascendinbg aorta. No complication was encountered in association with this procedure in 127 operations.

[The long-term anterior chest wound pain after the cardiac surgery].

We discussed on the long-term anterior chest wound pain after the cardiac surgery by using a questionnaire. The risk of the left anterior chest wound pain was high significantly in the cases using the left internal thoracic artery compared with other cases. Participation of the division of the left upper pericardium and the adjacent soft tissue was highly suggested as the cause of this pain.

[Coronary artery bypass grafting under the excellent heart exposure provided by the use of the coronary artery exposing tape].

We have used the coronary artery exposing tape devised by Akio Matsuura in 93 patients undergoing coronary artery bypass grafting. We could perform graft anastomosis more easily and safely by the use of this tape than by the conventional simple compression method of the heart with the gauzes. The heart was lifted anteriorly with the rotation by the tape pulled to the left side or to the caudal side. The right coronary artery branches were exposed excellently by the simple traction of the tape to the caudal side. The circumflex coronary artery branches were well exposed by one tape pulled to the left side and another tape to the right side over the heart with the counterclockwise rotation of the heart. In these procedures no complication was encountered in association with the traction of this tape.

Rupture of the innominate artery following tracheostomy: report of a case.

A 23-year-old man underwent a tracheostomy. A massive hemorrhage from the tracheostomy site occurred 50 days later. An emergency operation was immediately performed and an erosion was noted on the innominate artery. The artery was divided and the hemorrhage was successfully stopped.

[Cardiac surgery by the safe and easy insertion method with the J-shaped left ventricular vent catheter].

We experienced the safe and easy insertion method with the J-shaped left ventricular vent catheter. The catheter tip (about 15 cm) was vended in the J shape with the inner stainless steel introducer. This J-shaped catheter was inserted into the left atrium through the right upper pulmonary vein. Then this catheter was held vertically and only the outer silicone catheter was pushed into the left ventricle. In this method the catheter tip is turned to the front in the left atrium and inserted easily into the left ventricle along the anterior wall of the left atrium through the anterior margin of the mitral valve orifice.

Left ventricular free wall rupture following mitral valve replacement.

During a 10-year period, 110 patients underwent mitral valve replacement (MVR). We experienced three left ventricular ruptures among these patients. Two had a type I immediate rupture, and one had a type III delayed rupture. Two patients (type I, III) survived after repair of the rupture. It was possible to control bleeding by manual compression with oxidized cellulose, collagen mat and fibrin glue with or without external mattress sutures. Following the repair, an intra-aortic balloon pump and sedative agents were used in both patients. In the other patient with a type I early rupture, control of bleeding was attempted by external direct suture using Teflon felt. The bleeding was controlled by this repair and the use of a left ventricular assist device, but the patient died of a brain infarction 5 days after the operation. The manual compression technique using oxidized cellulose, collagen mat and fibrin glue may be useful for minor lacerations, and for reinforcing repairs. The intra-aortic balloon pump and continuous sedation are useful for unloading the ventricle and reducing the tension on repairs.

Omental transfer as a method of preventing residual persistent subcutaneous infection after mediastinitis.

Currently, poststernotomy mediastinitis frequently is being treated by debridement and immediate closure with omental drainage. This method is useful, but subcutaneous infection occasionally occurs. Divided omental transfer to the presternal space may be helpful in preventing this complication.

Lateral origin of the right internal thoracic artery: report of a case.

We report herein the unusual case of a patient in whom postoperative angiography following coronary artery bypass grafting (CABG) revealed a lateral origin of the right internal thoracic artery (ITA) and a normal origin of the left ITA, both of which were demonstrated to be patent and did not follow a tortuous course. The CABG had involved revascularization of the left anterior descending artery (LAD) with the right ITA, and the obtuse marginal artery with the left ITA. The patient had an uneventful postoperative course and developed no respiratory symptoms.

Controlled release of thyrotropin releasing hormone from microspheres: evaluation of release profiles and pharmacokinetics after subcutaneous administration.

The drug-release kinetics of thyrotropin releasing hormone (TRH) containing copoly(dl-lactic/glycolic acid) (PLGA) microspheres were evaluated both in vitro and in vivo. The drug was encapsulated in PLGA using an in-water drying method through a water in oil in water emulsion. The drug release from the PLGA microspheres in vitro correlated well with that in vivo, and pseudo-zero-order release kinetics were observed. The pharmacokinetics of TRH following administration of this controlled-release parenteral dosage form have been also examined in rats. Following a transient increase in the plasma level due to an initial burst, steady-state plasma levels were observed. The duration of drug release estimated from the plasma level was comparable with the results in the in vitro and in vivo release studies. The steady-state plasma levels correlated well with the levels predicted from the pharmacokinetic parameters following a single subcutaneous or intravenous injection of TRH solution. The results of this study confirm the previously reported in vivo sustained release of TRH achieved with this drug-delivery system.

Calvasculin, as a factor affecting the microfilament assemblies in rat fibroblasts transfected by src gene.

Cell transformations accompany alterations in cell morphology and microfilament patterns. Calvasculin encodes mRNA termed pEL-98, 18A2, 42A, p9Ka, or mts1, found to be elevated in several metastatic cell lines. We report the elevation of calvasculin expression in SR-3Y1 cells, which show disappearance of ordered microfilaments, compared to that in 3Y1 cells and that the similar distribution of calvasculin to that of actin filaments. Interestingly, calvasculin co-sediments with F-actin and bundles actin filaments in a Ca(2+)-dependent manner. This activity, along with the elevation of calvasculin following transformation, suggests that the disorganization of filaments in SR-3Y1 cell is due to the cross-linking activity of calvasculin.

Continuous retrograde cerebral perfusion for protection of the brain during aortic arch surgery.

Hypothermic circulatory arrest and selective cerebral perfusion for aortic arch surgery have been reported, but these procedures are of limited duration, require hazardous and complicated techniques and can cause clamp injury. Continuous retrograde cerebral perfusion (CRCP) is a new and simple technique for the protection of the brain during hypothermic circulatory arrest. We applied CRCP in 26 patients who underwent aortic arch surgery. Continuous retrograde cerebral perfusion was performed with a mean blood flow of 383 +/- 176, range 120-800, ml/min. The mean duration of CRCP was 63 +/- 15, range 32-92, min with the superior vena cava pressure at 15-42 mm Hg. No neurologic deficit was observed in 20 patients (90%) and only minor deficits in 2 out of the 22 cases without severe postoperative complications, allowing evaluation of the effectiveness of CRCP. Four patients had other severe complications, and the effectiveness of the method could not be evaluated. Continuous retrograde cerebral perfusion can be an excellent and safe technique which avoids clamp injury during aortic arch surgery.

Calcyclin and calvasculin exist in human platelets.

Using Ca(2+)-dependent affinity chromatography on a synthetic compound (W-7)-coupled Sepharose column, three distinct Ca(2+)-binding proteins have been identified in human platelets. The molecular mass of these three distinct proteins was estimated to be 10, 10.5, 17 kDa, respectively, by polyacrylamide gel electrophoresis in the presence of SDS. The partial amino acid sequence revealed these proteins have EF-hand structures and high homology to the predicted proteins, calcyclin, calvasculin, and calmodulin. Calcyclin and calvasculin have been considered as probably having roles in the control of cell proliferation, but the existence of these two proteins in platelets suggests that they have other intracellular functions related to the Ca(2+)-signal transduction system.