Coronary active perfusion system can maintain myocardial blood flow and tissue oxygenation.

OBJECTIVES: To avoid myocardial ischemia in off-pump coronary artery bypass, we developed a coronary active perfusion system (CAPS). The purposes of this study were to investigate the changes in myocardial blood flow and tissue oxygenation during CAPS perfusion, and to validate the ventricular arrhythmias and hemodynamic deterioration preventing the effect. METHODS: Sixteen pigs were divided into a CAPS perfusion group (group C) and a simple coronary occlusion group (group O). The left anterior descending coronary artery was snared in both groups and 30 min of CAPS perfusion was performed in group C. RESULTS: Ventricular arrhythmias were not observed in group C, but occurred in seven out of eight pigs in group O (P=0.003). None of the hemodynamic variables changed in group C, but they deteriorated in group O. Myocardial blood flow, saturation, and hemoglobin plus myoglobin concentration were maintained with a baseline level in group C, but decreased significantly in group O (P<0.001). CONCLUSION: CAPS is a reliable method to avoid myocardial ischemia during coronary occlusion and it may be useful for off-pump coronary artery bypass     

Hepatocyte growth factor (HGF) as a rapid diagnostic marker and its potential in the prevention of acute renal rejection

Several investigators have reported that hepatocyte growth factor (HGF) may be related to the protection or reconstruction of the kidney during acute renal rejection. To address this question, we examined the relationship between HGF and acute rejection in the following two studies with rat renal transplantation models. In study 1, the relationship between serum HGF levels and acute renal rejection in iso-, allo- and allograft with cyclosporine (CsA)-treated models was examined. In study 2, the focus was whether or not the injection of recombinant HGF can prevent acute renal rejection. Our results demonstrated that HGF levels were rapidly increased during acute rejection and that recombinant HGF effectively protected the kidney from acute rejection. These results suggest that HGF may be induced as a counter-response to the renal injury and that it can be used as a reliable indicator for the diagnosis of acute rejection. We suggest that recombinant HGF suppresses the onset of the pathological changes of acute rejection.     

Long-term survival of patients with hepatocellular carcinoma combined with liver cirrhosis. Report of two patients

Two patients with hepatocellular carcinoma combined with liver cirrhosis lived more than 5 years after hepatic resection. One patient with liver cirrhosis combined with schistosomiasis japonica survived 5 years and 2.5 months after left lobectomy and died of liver failure. Two recurrent tumors, each 1 cm in diameter, were present in the remaining lobe but were not responsible for death. Another patient is well 9 years and 2 months after extended right lobectomy. The tumor was bulky, and the resected specimen was 2800 g in weight. These facts show that patients with hepatocellular carcinoma combined with liver cirrhosis can survive for a long period even if a large tumor is involved.     

Two cases of apiaceae spice allergy]

BACKGROUND: Many cases of spice allergy have been reported especially from Scandinavian countries, but in contrast there are few reports in Japan. This time we experienced two cases of apiaceae spice allergy and practiced some kinds of examinations. We report here these two cases with the consideration concerning mechanism of spice allergy. METHODS AND SUBJECTS: We practiced 1) specific IgE of pollens and foods, 2) prick tests of spices and apiaceae vesitables, 3) immunoblot of spices, against two cases suspected spice allergy from their clinical courses. Clinically Case 1 32 y.o. male had been no history of pollinosis, in contrast Case 2 46 y.o. female had been suffered from pollinosis during spring and autumn seasons. RESULTS: In Case 1 the scores of specific IgE of pollens were almost negative and immunoblot examination of spices revealed positive reaction at the site of 10 approximately 12 kDa and 60 kDa. In Case 2 the scores of specific IgE of pollens were positive in many species and immunoblot examination of spices reacted positively at the site of 14 kDa and 60 kDa. Both of them showed positive reactions against many kinds of apiaceae spices in prick tests, so we diagnosed them as apiaceae spice allergy. CONCLUSION: According to these results we suspected Case 1 as class 1 allergy induced by the sensitization of spices themselves and Case 2 as class 2 allergy caused by the cross reactions with pollinosis. So there may be some different mechanisms in the occurrence of spice allergy. In the future the occurrence of spice allergy will be supposed to increase and it will be necessary for us to pay much more attention to spice allergy even in Japan.     

Efficacy and adverse effects of the coronary active perfusion system--from a viewpoint of perfusional timing.

We developed a coronary active perfusion system (CAPS) to avoid myocardial ischemia during off-pump coronary artery bypass (OPCAB). The purpose of this study was to determine the optimal timing of CAPS perfusion, and to investigate any adverse effects when it is driven within the systolic phase. Twenty-four pigs were divided into four groups: (A) systolic, (B) early-diastolic, (C) middle-diastolic, and (D) late-diastolic perfusion. Myocardial blood flow (MBF), hemodynamic and mechanical data were measured during 30 minutes of CAPS perfusion. MBF in group A was lower than in the other groups (p<0.001), but no significant differences were observed among groups B to D. End-systolic pressure-volume relation (Mw) and preload recruitable stroke work relation (Ees) in group A was lower than in groups B to D (p<0.01 and p<0.05, respectively), but no significant differences were observed among groups B to D. CAPS could maintain regional MBF and left ventricular function if it was driven only within the diastolic phase and required no strict adjustment, but CAPS has an adverse effect when it is driven in the systolic phase.     

Clinical evaluation of serum level of NCC-ST-439 as a new tumor marker for colorectal diseases--fluctuation of serum NCC-ST-439 in patients with colorectal cancers before and after surgery

Serum level of NCC-ST-439, a new tumor marker, was clinically evaluated in patients with benign and malignant colorectal diseases in comparison with serum CEA and CA 19-9. Fluctuation of serum levels of NCC-ST-439 in patients with colorectal cancers was especially studied. Serum level of NCC-ST-439 was determined by sandwich type NCC-ST-439 EIA kit, which was developed by Nippon Kayaku Co., Ltd., in 93 cases of primary colorectal cancers, 98 cases of recurrent colorectal cancers and 60 cases of benign colorectal diseases. Positive rate of serum NCC-ST-439 in patients with primary colorectal cancers was 8.6% in Dukes A cases, 14.3% in Dukes B cases, 37.5% in Dukes C cases and 78.9% in Dukes D cases. Positive rate in patients with recurrent colorectal cancers was 42.8%. On the other hand, false positive rate in patients with benign colorectal diseases was 5.0%, which was relatively low in comparison with serum CEA and CA 19-9. While serum NCC-ST-439 was well correlated with serum CEA and CA 19-9 in primary colorectal cancers, NCC-ST-439 value in benign colorectal diseases showed no correlation with serum CEA and CA 19-9. In patients with primary colorectal cancers, curative resection was applied for in 40 cases in which the value recovered to the normal range after resection. In contrast, all 8 cases, which received non-curative resection, showed the increase of serum NCC-ST-439 value. In cases of recurrent colorectal cancers, some cases, which responded against chemotherapy, obviously showed a decrease of NCC-ST-439 value. These facts indicated that serum level of NCC-ST-439 could monitor the clinical effects of surgical treatment, chemotherapy and radiation therapies and it could be used as a marker for colorectal cancers. In conclusion, determination of serum NCC-ST-439 value was clinically useful for the diagnosis and monitoring for patients with colorectal cancers as a new distinct tumor marker.     

Presenilin-1 Polymorphism in Alzheimer''s Disease and Vascular Dementia

Recent reports suggest an association between an intronic polymorphism at the 3′ position of exon 8 of the presenilin-1 (PS-1) gene and late-onset Alzheimer's disease (AD), but little is known about its role in the pathogenesis of AD. By genotyping 193 Japanese patients with vascular dementia or AD, and 186 elderly control subjects, we have shown no association between vascular dementia and this PS-1 polymorphism, though PS-1 genotype 1/1 and allele 1 frequencies were both significantly higher among patients with AD than among controls. These results argue for a specific role of PS-1 allele 1 in the pathogenesis of AD, rather than suggesting a broader role for this allele as, for example, in vascular dementia.     

Totally Implantable Ventricular Assist System Using a Vibrating Flow Pump

Abstract: A totally implantable ventricular assist system (VAS), including a drive system and a percutaneous electric energy transmission system, was developed and evaluated in acute animal experiments using adult goats. This newly designed VAS mainly consists of a vibrating tube, coils, magnets, and a jelly-fish valve as the outlet valve. For energy transmission, a new implantable transmitter with a plain weave structure was proposed as a noncon-tacting transform by using the spinal amorphous magnetic fibers. The fluid mechanical and hemodynamic properties and the efficiency of the energy transmission system were evaluated in acute animal experiments using healthy adult goats. This vibrating electromagnetic artificial heart (AH) could generate more than 10 L/min as output volume, with 10 Hz vibration using 20 volts as supplied voltage. The total efficiency of the percutaneous energy transmission system was 76%, and temperature increases were within the acceptable range, suggesting the usefulness of our newly developed implantable VAS.     

Chaotic Hemodynamics During Oscillated Blood Flow

Abstract: A vibrating flow pump (VFP), which can generate oscillated blood flow (10–50 Hz/min), has been developed by our team for the artificial heart system. However, the flow pattern of this pump was different from that of the natural heart; therefore, it is important to analyze the effect of this oscillated blood flow on the circulatory regulatory system. To analyze the hemodynamics of high frequency oscillated blood flow as an entity, (not decomposed), nonlinear mathematical techniques were utilized. VFPs were implanted between the left atrium in animal experiments using adult goats. After the implantation procedure, the ascending aorta was clamped to constitute the complete left heart circulation with VFP. Using a nonlinear mathematical technique, an arterial blood pressure waveform was embedded into four–dimensional phase space and projected into three–dimensional phase space. The Lyapunov numerical method was used as an adjunct to graphic analysis of the state space. Phase portrait of the attractor showed a high dimension complex structure, suggesting deterministic chaos during natural circulation. However, phase portrait of the hemodynamics during oscillated blood flow showed a single circle with banding and a forbidden zone, similar to a limit–cycle attractor, suggesting a lower dimensional dynamic system. Positive Lyapunov exponent during oscillated blood flow suggests the existence of lower dimensional chaotic dynamics. These results suggest that the circulatory regulatory system during oscillated blood flow may be a lower dimensional homeochaotic state; thus, hemodynamic parameters must be carefully regulated when unexpected external stimuli are present.