Circulating adhesion molecules in patients with vibration-induced white finger

We investigated whether a relationship existed between soluble adhesion molecules and vascular damage from vibration-induced white finger. Thirty-five men exposed to vibration and 40 healthy control subjects were examined. Concentrations of soluble E-selectin intercellular adhesion molecules, and vascular cell adhesion molecules in serum were measured with sandwich enzyme-linked adhesion immunosorbent assay. Neither E-selectin nor intercellular adhesion molecule levels are elevated in men exposed to vibration with white finger compared to levels in men exposed to vibration without white finger and control subjects. The serum level of soluble vascular cell adhesion molecules is significantly increased in patients with vibration-induced white finger.     

Long-term follow-up study on patients with vibration-induced white finger (VWF)

The prognosis of vibration-induced white finger was investigated with a long follow-up period. From 1975 to 1994, 99 men with hand-arm vibration syndrome who received the annual compulsory examination at San-in Rosai Hospital were followed up for 15 years or longer. Based on the extent of finger-blanching attacks described in the medical records, they were classified according to the vascular stage of the Stockholm workshop scale. In our laboratory, finger systolic blood pressure (FSBP) measurement after finger cooling has been performed since 1989. We compared the stage classification with the results of FSBP measurement after finger cooling in the period 1989-1994. The stage 2 and stage 3 groups showed a significant decrease in FSBP% compared with the stage 0 group. The vascular stage classification based on subjective symptoms in this study was to a certain extent reliable. Although vibration-induced white finger symptoms tended to improve to some extent, 43.2% and 70.4% of patients with stage 2 and stage 3 at first examination, respectively, still suffered from finger blanching attacks after 15 years of observation. Blanching of fingers in advanced stages, especially stage 3, was found to be persistent many years after cessation of vibration exposure.     

Evaluation of 18F-FDG PET in acute ischemic stroke: assessment of hyper accumulation around the lesion

PURPOSE: Although pathophysiology of cerebrovascular disease has been reported previously, few clinical studies of glucose metabolism in acute stroke have been published. Purpose of this study is to evaluate glucose metabolism in acute stroke patients by 18F-FDG PET. SUBJECTS AND METHODS: Twenty-four patients with acute ischemic stroke were involved in this study. All subjects underwent MRI (conventional T1- and T2-weighted images, diffusion-weighted imaging, and MR angiography), CT and 18F-FDG PET. 18F-FDG PET was performed within 1 to 7 days after the first episode. 18F-FDG PET images were visually evaluated as well as MRI and CT images. RESULTS: Four patients out of 24 showed no abnormal 18F-FDG accumulation, while MRI demonstrated abnormal signal area and abnormal vascular findings that suggested acute stroke. Decreased 18F-FDG accumulation corresponding with abnormal signal area on MR images was noted in 20 cases. In 7 cases among these 20 with decreased 18F-FDG, hyper accumulation of 18F-FDG was recognized around the decreased accumulation area. CONCLUSION: Increased 18F-FDG accumulation (increased glucose metabolization) around the lesion may be due to: 1) acceleration of anaerobic glycolysis, 2) activated repair process of damaged brain tissue, i.e., phagocytosis and gliosis, and 3) neuronal excitation by excito-toxic amino acids which can be released after ischemia.     

Coronary artery calcification score measured by electron beam computed tomography for evaluation of ischemic heart disease in Japanese

The objective of this study was to assess the usefulness of coronary artery calcification score(CACS) as measured by electron beam computed tomography(EBT) for evaluating coronary artery disease(CAD) in the Japanese population. The study included 513 consecutive patients(384 men and 129 women). All patients underwent EBT, and CACS was calculated. A total of 346 of 379 patients were diagnosed with CAD by coronary arteriography(> 50% stenosis), and 33 had previous myocardial infarction. CAD was ruled out in the other 134 patients. All subjects were divided into 8 groups according to age (years) (I: up to and including 49, II: 50-59, III: 60-69, IV: 70 and over) and gender. There were significant differences in mean CACS between CAD patients and non-CAD patients in all age groups(p < 0.01). Receiver operating characteristic(ROC) analysis was performed. Cut-off points, obtained by the area under the curve, ranging from 0.75 to 0.95 were determined as useful for the diagnosis of CAD. According to ROC analysis, the corresponding scores of the cut-off point for each group were calculated to be as follows: 80% sensitivity(men: 6, 15, 104, 318; women: 0.1, 6, 118, 196), 90% sensitivity(men: 1, 2, 39, 107; women: 0.1, 0.1, 11, 42), 90% specificity(men: 24, 430, 602, 658; women; 13, 2, 118, 416). These cut-off points for CACS may be useful in the diagnosis of CAD in the Japanese population.     

Spatial focusing of neuronal responses induced by asynchronous two-tone stimuli in the guinea pig auditory cortex

Spatiotemporal patterns of neuronal responses to asynchronous two-tone stimuli in the anterior field of the auditory cortex of anesthetized guinea pigs were studied using an optical recording method (12 x 12 photodiode array, voltage sensitive dye RH795). Interactions between the onset response to the first tone (masker; 5, 8, 10, 12 and 15 kHz, 200 ms) and to the second tone (probe; 10 kHz, 30 ms) with onset delays relative to the masker onset (0, 5, 10, 15 and 20 ms) were investigated. In general, two-tone interaction was suppressive rather than facilitative. At 0-10 ms probe delays, two-tone responses induced in the probe isofrequency area on the cortex tended to fuse with the masker response. At 15-20 ms probe delays, the probe response was apparently reduced, but was spatially focused and separated from the masker response. This spatial focusing of the probe response may have been due to neuronal inhibition originating after the masker onset response. These results are in agreement with psychoacoustical observations in human subjects, such as auditory segregation, and indicate that the spatial focusing of the cortical response provides a neuronal basis for detecting slightly asynchronous auditory inputs.     

Healing in the intestinal anastomosis--comparison of the Albert-Lembert and Gambee methods

An experimental comparative histomorphological study was made on intestinal healing processes following an Albert-Lembert suture with approximation of the serosal surface and Gambee's layer to layer anastomosis of a dog. There was no obvious complications such as postoperative hemorrhage, anastomotic stenosis or anastomotic leakage. Although both anastomoses resulted in a good healing process, Gambee's layer to layer suture, which caused the submucosal layers to face each other, showed better wound healing at the anastomosis in terms of layer to layer attachment. As a conclusion, Gambee's layer to layer anastomosis seemed to be a better anastomotic technique in terms of wound healing for the intestinal anastomosis.     

Mechanisms of the depolarization and contracture due to Na removal in the circular muscle of the guinea-pig stomach

Verapamil (10(-6) M) significantly reduced a development of the membrane depolarization and the contracture which were induced by Na removal. The fully developed depolarization, after exposure to Na-free solution, was reduced greatly by verapamil, excess Ca (15 mM) or sodium nitroprusside (10(-6) M), but some depolarization still remained. This remaining depolarization was completely blocked by readmission of 10 mM Na to Na-free solution containing verapamil, excess Ca or sodium nitroprusside. However, Mn (1.5 mM) did not block the depolarization due to Na removal and if Mn was present in Na-free solution, readmission of 15 mM Na to Na-free solution was not able to block the depolarization. On the other hand, the contracture due to Na removal was inhibited by addition of Mn (1.5 mM) or sodium nitroprusside (10(-6) M), but partially by addition of verapamil (10(-6) M) or excess Ca, to Na-free solution. These remaining contractures were also abolished by readmission of 10 mM Na to Na-free solution containing verapamil or excess Ca. Thus, these results suggest that the depolarization and the contracture due to Na removal are induced by increase in cytoplasmic Ca concentrations through (1): verapamil-sensitive Ca channel, (2): Na-Ca exchange system and (3): some mechanism which is inhibited by sodium nitroprusside.     

Prospective Randomized Comparative Study of Antibiotic Prophylaxis in Urethrocystoscopy and Urethrocystography

Background : There has been a great deal of discussion regarding the necessity of the prophylactic use of antibiotics in transurethral procedures. In order to clarify this complicated issue, a randomized prospective study was performed for patients undergoing urethrocystoscopy or urethrocystography.
Patients and Methods : Patients who underwent urethrocystoscopy or urethrocystography and did not have pyuria and bacteriuria were included and divided randomly into 2 groups, either receiving a prophylactic antibiotic or no antibiotic. For antibiotic prophylaxis, 200 mg of sparfloxacin or fleroxacin were administered within a 1-hour period before the urethrocystoscopic or urethrocystographic examination, respectively. Analyses were performed on patients who were seen within 1 month after the examination, using the appearance of pyuria, bacteriuria, or a febrile infection as the endpoint.
Results : Of47 patients undergoing urethrocystoscopy, 45 were eligible for analysis, and of these, sparfloxacin was administered to 21 patients. Thirty-three of 37 patients undergoing urethrocystography were eligible for analysis with fleroxacin administered to 16 patients. There were no significant differences in the background factors between the 2 groups undergoing either transurethral examination. None of the patients in either group developed pyuria, bacteriuria or a febrile infection after the examination.
Conclusions : Prophylactic administration of antibiotics is not necessarily essential in urethrocystoscopy or urethrocystography in patients with sterile urine.     

Mechanisms of increase in amylase activity in rat submandibular and sublingual glands after administration of pilocarpine

The increase in parotid rather than pancreatic-type amylase activity in the submandibular and sublingual glands of rats caused by administration of pilocarpine was abolished or diminished when pilocarpine was injected into rats which had been parotidectomized, sympathectomized by superior cervical ganglionectomy or pretreated with reserpine. These results suggest that the increases in amylase activity in the submandibular and sublingual glands by pilocarpine are not due to increase in enzyme synthesis, but to uptake of enzyme released into the blood in large quantities from the parotid gland and that the release from the parotid gland by pilocarpine is primarily mediated by sympathetic nerves.