Non-invasive tissue oxygen monitoring by near-infrared spectroscopy

Biological tissues are relatively transparent to light in near infrared region. Brain oxygen metabolism was non-invasively studied by the simultaneous measurement of hemoglobin (Hb) oxygenation and cytochrome oxidase (Cyt. aa3) redox state in the rat brain using near infrared transmission spectrophotometer. Wavelength pairs at 700-805 nm and 830-805 nm were used for the measurements of Hb oxygenation level and of the redox state of cyt. oxidase in situ. Change in the brain blood volume was also monitored by the absorption change at 805 nm. Our estimation of the oxygenation level of brain Hb revealed that present optical measurement picks up mainly that of venous blood. Sharp reduction of the oxidase occurred at the oxygen concentration below 15% in the inspired gas. But above 30% O2, about 85% of the cyt. oxidase was in the oxidized state which was almost constant up to 100% O2. Applications of our techniques for the studies of brain metabolism in acute hemorrhage and in Ca++-antagonist administration were also presented. This non-invasive optical method for the study of human brain metabolism is concluded to be a promissing technique.     

The inhibitory effect and the mechanism of ethanol absorption by L-carnosine zinc complex in mouse gastrointestinal tract]

The effect of L-carnosine-zinc complex(Car-Zn) on ethanol absorption was investigated after oral administration(adm) to mice. One hour after oral adm of Car-Zn, and 14C-ethanol was given orally or intraperitoneally(i.p.). After passage of time, the blood was drawn from the tail vein, and 14C-radioactivities determined. The Car-Zn showed a dose-dependent inhibition of the appearance of 14C-radioactivities in blood following oral 14C-ethanol loading, while Zn acetate did not induce any alteration as compared with control. Car-Zn pretreatment did not induce any change in the blood 14C-radioactivity when ethanol was given i.p. The 14C-radioactivity and zinc in gastrointestinal tract after oral adm of Car-Zn and 14C-ethanol showed significantly higher levels than those of control for 7 hr. Distribution of 14C-radioactivities in other organs of Car-Zn treated mice were lower than those of control 3 hr after adm, while it was similar or higher than those of control 7 hr after adm. The excretions of 14C-radioactivity through expiration in Car-Zn group was a lower than that of control. Also, the urinary and fecal excretions of 14C-radioactivity were low values at 5.0% and 0.5% of the administered dose 72 hr after adm, respectively. Also, the 14C-radioactivities remaining in the organs did not detect or were very low values. In vitro study, Car-Zn stimulated the metabolism of ethanol to acetaldehyde and acetic acid in 9,000 g supernatant of small intestine. The major route of excretions of 14C-radioactivity may be excreted into the expired air. The results suggest that Car-Zn shows a long-term adhesive and permeable action on gastrointestinal tract in the mouse; as a result, this may inhibited ethanol absorption.     

Whole-Genome Sequencing of Shiga Toxin–Producing Escherichia coli OX18 from a Fatal Hemolytic Uremic Syndrome Case

We report a fatal case of hemolytic uremic syndrome with urinary tract infection in Japan caused by Shiga toxin–producing Escherichia coli. We genotypically identified the isolate as OX18:H2. Whole-genome sequencing revealed 3 potentially pathogenic lineages (OX18:H2, H19, and H34) that have been continuously isolated in Japan.     

Evaluation of two prognostic indices for adult T‐cell leukemia/lymphoma in the subtropical endemic area,Okinawa, Japan

Aggressive adult T‐cell leukemia/lymphoma (ATL) has an extremely poor prognosis and is hyperendemic in Okinawa, Japan. This study evaluated two prognostic indices (PIs) for aggressive ATL, the ATL‐PI and Japan Clinical Oncology Group (JCOG)‐PI, in a cohort from Okinawa. The PIs were originally developed using two different Japanese cohorts that included few patients from Okinawa. The endpoint was overall survival (OS). Multivariable Cox regression analyses in the cohort of 433 patients revealed that all seven factors for calculating each PI were statistically significant prognostic predictors. Three‐year OS rates for ATL‐PI were 35.9% (low‐risk, n = 66), 10.4% (intermediate‐risk, n = 256), and 1.6% (high‐risk, n = 111), and those for JCOG‐PI were 22.4% (moderate‐risk, n = 176) and 5.3% (high‐risk, n = 257). The JCOG‐PI moderate‐risk group included both the ATL‐PI low‐ and intermediate‐risk groups. ATL‐PI more clearly identified the low‐risk patient subgroup than JCOG‐PI. To evaluate the external validity of the two PIs, we also assessed prognostic discriminability among 159 patients who loosely met the eligibility criteria of a previous clinical trial. Three‐year OS rates for ATL‐PI were 34.5% (low‐risk, n = 42), 9.2% (intermediate‐risk, n = 109), and 12.5% (high‐risk, n = 8). Those for JCOG‐PI were 22.4% (moderate‐risk, n = 95) and 7.6% (high‐risk, n = 64). The low‐risk ATL‐PI group had a better prognosis than the JCOG‐PI moderate‐risk group, suggesting that ATL‐PI would be more useful than JCOG‐PI for establishing and examining novel treatment strategies for ATL patients with a better prognosis. In addition, strongyloidiasis, previously suggested to be associated with ATL‐related deaths in Okinawa, was not a prognostic factor in this study.     

Prognostic relevance of tumor-resident memory T cells in metastatic lymph nodes of esophageal squamous cell carcinoma

Tumor-resident memory T (T_RM) cells in primary tumors are reportedly associated with a favorable prognosis in several malignancies. However, the behaviors and functions of T_RM cells in regional lymph nodes (LNs) of esophageal cancer remain poorly understood. The aim of this study was to elucidate the effects of T_RM cells in regional LNs of esophageal cancer on clinicopathological findings and prognosis. Specimens of esophageal cancer and primary metastatic LNs (recurrent nerve LNs) were obtained from 84 patients who underwent radical esophagectomy between 2011 and 2017. We performed immunohistochemistry to enumerate and analyze T_RM cells, and used flow cytometry to investigate the function of T_RM cells. T_RM cells were observed in both metastatic LNs and primary tumors. T_RM cell-rich specimens exhibited reduced lymphatic invasion and LN metastasis and prolonged survival compared with T_RM cell-poor specimens. T_RM cells in metastatic LNs were more significantly associated with enhanced survival than T_RM cells in primary tumors. T_RM cells expressed high levels of granzyme B as a cytotoxicity marker. Our results suggested that high T_RM cell infiltration in metastatic LNs improves survival even though LN metastasis is commonly associated with poor prognosis. T_RM cells possibly contribute to antitumor immunity in regional LNs.     

Surgical strategy for long-standing dislocation of the temporomandibular joint: experience with 16 medically compromised patients

We evaluated the surgical outcomes in 16 patients with long-standing dislocation of the temporomandibular joint (TMJ): eight men and eight women, mean (range) age 72 (21-94) years. They all had multiple underlying diseases, either dementia or a mental disorder, and the joint had been dislocated for four weeks or longer. Manual reduction had been ineffective. They were operated on after assessments by the Department of Geriatric Medicine. The procedures were successful in 14 of the 16 patients: eminectomy (n = 5), eminectomy and discectomy or condylectomy (n = 2), eminectomy, discectomy, and condylectomy (n = 3), release of the lateral pterygoid muscle (n = 3), and curettage of a fibrotic scar in the mandibular fossa (n = 1). Reduction was “easy” (n = 4), “moderately difficult” (n = 3), or “very difficult” (n = 9). Complete reduction could not be achieved for two of the “very difficult” patients. After reduction, three patients had the mandibular condyle tethered to the mandibular fossa. Operation was successful in 12 of the 16 patients. Two patients died, one of cardiopulmonary arrest, and one of chronic pulmonary insufficiency, while reduction was incomplete in two. There were no recurrences. The difficulty of reducing the joint in most of our patients suggests that detailed preoperative surgical planning is essential, patients at risk should be carefully selected, and indications for techniques to prevent recurrence should be carefully evaluated.     

Outcomes of Patients with Hepatocellular Carcinoma Treated with Conventional Transarterial Chemoembolization Using Guidance Software

Purpose

To evaluate the outcomes of conventional transarterial chemoembolization using guidance software for hepatocellular carcinoma (HCC) patients.