Contribution of Monoamine Oxidase(MAO) to the Binding of Tertiary Basic Drugs in Isolated Perfused Rat Lung

The effect of tertiary basic drugs on mitochondrial MAO activity and the effect of MAO inhibitors (MAOIs) on basic drug accumulation in the isolated perfused rat lung were studied to clarify the role of MAO in drug binding to lung tissue. In the perfused lung preparation, the inhibition of MAO by basic drugs correlated well with their lipid solubilities and followed competitive kinetics. The inhibitory rank order (imipramine diphenhydramine > quinine > metoclopramide > procainamide) also correlated with their accumulation in the perfused lung. Moreover, MAOI treatment decreased the accumulation of basic drugs in the lung, and the potency of MAOIs to inhibit drug accumulation in the lung correlated with their MAO inhibitory activity. These results indicate that lung MAO has specific binding sites for basic drugs and may function as a drug reservoir.     

Results of combined therapy of irradiation and intra-arterial one-shot injection of cisplatin for head and neck cancers

Thirty-six previously untreated cases of head and neck cancer were given a combined therapy of irradiation and intra-arterial, one-shot injection of Cisplatin. As a result, the primary lesions in 35 cases were seen to achieve a 66% complete remission (CR) and a 100% overall response (OR). The lymph metastases in twenty-one cases with positive node achieved a 62% CR and a 100% OR. Good, local control of supraglottic and hypopharyngeal cancers were found to be an advantageous factor considered from the standpoint of the "quality of life". The cumulative survival rate, using Kaplan-Meier's method, was 82% for the first year, and 62% for the second year. No severe side effects were observed.     

Use of a pericardial fat pad flap for preventing bronchopleural fistula: An experimental study focusing on the angiogenesis and cytokine production of the fat pad

An experimental study was conducted to determine whether pericardial fat tissue could induce neovascularization and produce cytokines related to tissue repair. Neovascularization was examined using chick chorioallantoic membranes. Pieces of pericardial fat tissue, omentum, and intercostal muscle were individually placed on a number of chorioallantoic membranes and neovascularization induced by each material was assayed 6 days after the implantation. The intensity of neovascularization was in the order of pericardial fat omentum > muscle. Cytokines, such as interleukin 1 (IL-1) and , tumor necrosis factor- (TNF), interferon- (IFN-), and interleukin 6 (IL-6) were assayed in a culture supernatant of pericardial fat tissue. The latter was obtained 24h after the addition of lipopolysaccharide (LPS) following various incubation times. All cytokines other than IFN are known to play a part in tissue repair, whereas IFN is negatively related to tissue repair because it inhibits fibroblast growth. The pericardial fat tissue incubated with LPS produced a certain amount of IL-1 on day 1, and TNF on days 1 and 8, whereafter these values decreased to an undetectable level. Irrespective of the addition of LPS, a large amount of IL-6 was observed in the supernatant of pericardial fat tissue and it was detectable until day 29. On the contrary, INF was not detected at any assay time. These observations suggest that a pericardial fat pad flap could possibly be beneficial in the prevention of bronchopleural fistula after pulmonary resection.     

High Cervical Disc Lesions in Elderly Patients – Presentation and Surgical Approach

Summary  The incidence of high cervical disc lesions is extremely rare, and the mechanism of their development is unclear. We report these three cases, and discuss the possible mechanisms. We also describe surgical strategies for these lesions.  The first and second cases were an 82-year-old male and an 84-year-old male with retro-odontoid disc hernia. The third was an 83-year-old female with a herniated disc at C2/C3. To investigate Aetiological mechanisms of these lesions, we examined the findings on cervical images in extension and flexion, and compared the results in a younger than 80-year-old group and an older than 80-year-old group.  The patients underwent surgery via a posterolateral intradural approach. Wide laminectomy and incision of the dentate ligaments enabled access to the ventral space of the upper cervical spinal canal and sufficient decompression. All patients became ambulatory postoperatively without special fixation of the cervical spine. In the younger group, the level mostly loaded during cervical movement was C5/6, however, the levels in the older group were C2/3 and C3/4.  In elderly patients, less mobilization of the middle and/or lower cervical spine due to spondylotic change causes overloading at higher levels resulting in high cervical disc lesions. Retro-odontoid disc lesions can be caused by a herniated disc at C2/C3, which migrates upward. Regarding surgical strategy, the posterolateral intradural approach is less invasive and more advantageous for these lesions.     

Remnant omental transfer for the mediastinitis after coronary bypass surgery with right gastroepiploic artery.

A one-stage procedure for the treatment of mediastinitis after coronary bypass surgery utilizing the right gastroepiploic artery is described. This procedure consists of thorough debridement of mediastinal pus and necrotic tissue, excision of infected sternal bone, mediastinal irrigation, and immediate transfer of the "remnant" omental pedicle based on the "left" gastroepiploic artery without postoperative drainage or irrigation. Recently, this procedure was applied to our patients followed by excellent results.     

Extent and duration of isobaric 0.5% bupivacaine spinal anesthesia by using new open-end pencil point spinal needle

Extent and duration of isobaric 0.5% bupivacaine spinal anesthesia by using two spinal needles; a new 25 gauge open-end pencil point spinal needle (needle tip is open as a hole after pulling out the stylet, Doctor Japan Co., Japan) and a 25 gauge Quincke needle (TOP Co., Japan) were studied clinically in 24 patients for elective lower extremity surgery. Patients were randomly assigned into two groups of 12 patients each according to the spinal needle used. Lumbar puncture was performed between L3-4 with the patient in lateral decubitus position. After isobaric 0.5% bupivacaine 4.0 ml was injected in 20 seconds, the patient was placed in supine position, and the onset of anesthesia was assessed by loss of cold sensation (alcohol sponge), sensory block (pinprick) and motor block (modified Bromage's scale) in every 5 minutes until 30 minutes. Recovery of motor block and adverse effects were assessed by a blinded observer. Sensory block at 30 minutes by Quincke needle was Th 8.4 +/- 1.0 and by new open-end pencil point needle it was Th 8.5 +/- 3.2 dermatomes. Two groups did not differ significantly in sensory block and also in motor block. No adverse effect was observed in both groups. These results indicate that this new open-end pencil point spinal needle is very useful for preventing adverse effects of spinal anesthesia.     

Case study of paired cadaver renal allografts from the same donor: influence of local DIC kidney and concomitant acute rejection on early graft outcome

We report the clinical course of 2 recipients whose renal allografts were obtained from the same cadaver donor after cardiac arrest. The recipients showed different outcomes after transplantation. Graft biopsy after reperfusion revealed disseminated intravascular coagulation (so-called DIC kidney) and severe acute tubular necrosis (ATN) in both recipients. While one graft showed primary nonfunction, the other graft became functional after a post-operative anuric period. Serial graft biopsies performed during the oligo-anuric period revealed recovery of ATN and no intra-glomerular fibrin thrombi, but development of acute rejection was detected in both recipients. The left kidney graft showed more severe local DIC kidney than the right kidney, as well as more severe acute rejection in the oligo-anuric period. Despite aggressive anti-rejection therapy, the left kidney graft showed primary nonfunction. Therefore, severe acute rejection leading to primary nonfunction might have been related to more severe ischemic injury and more extensive local DIC kidney in the left kidney.     

IgA interaction with carboxy-terminal 43-kD fragment of fibronectin in IgA nephropathy

IgA deposition in the glomerular mesangial matrix is a prerequisite for the diagnosis of IgA nephropathy, and circulating IgA-containing complex has been implicated in this process. Since fibronectin is known to be involved in the assembly of extracellular matrix, this study was conducted to investigate whether fibronectin and its fragments are present in sera of patients and are capable of binding IgA1. Sera from patients with IgA nephropathy were purified by heparin-affinity chromatography, and column eluate were analyzed for the presence of fibronectin using Western blot and a set of anti-fibronectin monoclonal antibodies. Native fibronectin was digested with cathepsin D to obtain fragments similar to those of serum fibronectin. The capacity of fibronectin to bind IgA was examined with a mixture of purified IgA1 and cathepsin D-digested fibronectin fragments. A 43-kD carboxy-terminal fragment of fibronectin was detected in samples derived from sera of patients with IgA nephropathy but not in healthy control subjects. A similar-sized fragment was generated by cathepsin D digestion of the native molecule and was shown to bind to IgA1 in vitro. Since the carboxy-terminal domain is known to be critical in assembling exogenous fibronectin into the extracellular matrix, the affinity to IgA1 to a fragment found in patients may have pathogenic potential to mediate extracellular IgA deposition in IgA nephropathy.     

Expression of heat shock proteins in developing and degenerating rat testes

In the testis, several types of heat shock proteins (HSPs) have been identified and characterized, although the cellular basis of the HSPs remains elusive. In the present study, alterations in the cellular localization of HSPs, including HSP 25, 60, 70, and 90, were studied during the developing and degenerating periods in the rat testis using immunohistochemistry and Western blotting. HSP25 was expressed in neither germ cells nor somatic cells on all days examined. In contrast, HSP 60 was expressed in Leydig cells during neonatal and prepuberty periods, and only in spermatogonia and primary spermatocytes after puberty. HSPs 70 and 90 were expressed in germ cells, Sertoli cells, and Leydig cells during neonatal and early developing testes, and in spermatocytes and round spermatids after puberty. Besides, there was faint expression of HSP 90 protein in spermatogonia in this period. In the degenerative condition, all HSP proteins were markedly expressed in germ cells after surgery. It would appear that HSPs play roles in unique homeostasis in testes.