Improved high performance liquid chromatography determination of hippuric acid and methylhippuric acid isomers in urine

A study was made on the effect of detection wavelength and separation mode of HPLC on determination of urinary hippuric acid (HA) and three isomers of methylhippuric acid (MHA). The interference of other constituents of urine in the determination was effectively decreased by detection at a short wavelength of 227.6 nm. Meta and para MHAs were separated by the addition of beta-cyclodextrine to the mobile phase. Four metabolites were successfully separated from other components of urine by the combination of ODS-silica packed-column and mobile phase (method F). The detection limits were found to be 50 and 5 mg/l for HA and MHAs, respectively. MHAs could not be detected in the non-exposed subjects. Average levels (+/- SD) of HA in non-exposed males and females were 272.2 (+/- 210.8) and 393.0 (+/- 269.8) mg/l, respectively. The urinary levels of HA in females were significantly higher than those in males.     

Clinical study of respiratory infections complicating bronchial asthma]

We conducted a clinical study on respiratory infections complicating bronchial asthma. Transtracheal aspiration (TTA) was performed 37 times in 22 patients. The most frequently isolated organism was H. influenzae. The patients in whom organisms were isolated on TTA had a high incidence of fever and evidence of inflammation. Antimicrobial therapy caused a decrease in indices of inflammation (white blood cell count and ESR), but was less effective against the asthmatic symptoms. Respiratory infection may play a complex role in the clinical picture of bronchial asthma.     

Crystal-matrix interrelations in brushite and uric acid calculi

Brushite and uric acid calculi were studied by means of scanning electron microscopy with the partial dissolution method and transmission electron microscopy. Brushite calculi consist of radially oriented columnar crystals which have sheet-like substructure. The organic matrix is identified chiefly at the outside of the crystals but partly included between the substructure. The concentric matrix bands are often dislocated between the neighbouring crystals. Uric acid calculi also consist of radially oriented columnar crystals, and a fine meshwork of the organic matrix is incorporated within the crystals. The concentric matrix layers of different density are angled according to the crystal lattice. These findings indicate that the organic matrix arose from a mucinous surface coat, at least in the radially striated calculi. The crystals continued to grow in this gel-state milieu, either thrusting the matrix aside or incorporating it within the crystals.     

Baseline study of sleep electroencephalography--daily variation and individual variation

The aims of the present study were to observe the daily habituation to night sleep in a laboratory environment and to make clear the daily and individual sleep variations by using polygraph parameters, including electroencephalography (EEG). Sleep EEG records were obtained from a subject who slept ten successive nights, and from six subjects who each slept one night in the laboratory. The parameters used were as follows: sleep stage %, sleep latency (SL), REM latency (RL), number of stage shifts, subjective sleep, integral EMG, and slope (a) and intersect (b) of a regression equation used to estimate the sleep depth against sleep time. Stage WAKE and SL, slope (a), intersect (b) and the mean depth of sleep were found to become stable from the fifth night. Stage MT, the number of stage shifts, and integral EMG increased significantly from the fifth night and later, showing p less than 0.01, p less than 0.01, and p less than 0.05, respectively. Judging from these findings, the sleep habituation of the subject in the laboratory was completed within the first four nights. Coefficients of variation of sleep stage 2 and stage REM of the ten-nights' EEG were the lowest among all the sleep parameters examined. Almost all the parameters of day-to-day sleep of the subject who slept for ten successive nights in the laboratory showed smaller variations than those of the other six subjects. It may be concluded that the mist effect on sleep could be assessed more precisely by using an individual repeatedly than by using a group of subjects.     

Surgical treatment of hypoplastic left heart syndrome: a successful case report

A successful case of Norwood operation for a 5-day-old infant with hypoplastic left heart syndrome is reported. Norwood procedure and central shunting with a 4 mm PTFE tube was performed. Cerebral and coronary artery were perfused independently during reconstruction of aorta in order to shorten the time of circulatory arrest. Post operative UCG documented un-obstructive systemic output from the right ventricle, well regulated pulmonary arterial blood flow and widely patent interatrial communication. This baby was discharged the hospital 66 days after surgery. He has been clinically well for six month after the operation.     

EFFECTIVENESS OF CYTODIAGNOSIS WITH PANCREATIC DUCT LAVAGE FLUID FOR PANCREATIC DUCTAL CARCINOMA: NEW SAMPLING TECHNIQUE

Background: Pancreatic carcinoma is one of the most lethal cancers. Because pancreatic carcinoma is still very difficult to diagnose in its early stage, many of these patients will be considered unsuitable for surgery. If a cytological diagnosis is obtained at initial endoscopic retrograde cholangiopancreatography (ERCP), suitable treatment will be initiated without delay. Methods: To increase the number of exfoliated cells from the pancreatic duct, we devised a new technique, pancreatic duct lavage fluid (PDLF), following bronchoalveolar lavage fluid. The present paper reports the effectiveness of cytological examination using PDLF in the diagnosis of pancreatic carcinoma. We examined 18 pancreatic carcinoma cases. After the endoscopic retrograde pancreatography (ERP), PDLF was collected from a double‐lumen catheter inserted into the main pancreatic duct. Saline injected from the lumen for the injection, and PDLF was aspirated from the other lumen for the guidewire at the same time. The cytological examination was performed using PDLF. Results: Exfoliated cells were more frequently found in PDLF from all patients. In 15 cases (83%), cytological examination of PDLF revealed positive cytological results as the diagnosis of pancreatic carcinoma. Conclusion: Cytological examination using PDLF has a high sensitivity for detection of pancreatic carcinoma. The new examination, PDLF, is simple, safe and effective, so we expect PDLF to become widely popular.     

A case report of aorto-pulmonary window associated with atrial septal defect]

The patient was a one-year-old boy, who underwent surgery with a diagnosis of atrial septal defect (ASD). During operation, aorto-pulmonary window (A-P window) which had not been detected by the preoperative examinations, was found. Therefore, the A-P window was divided prior to closing ASD. The patient is in good condition six months after the operation. The causes of the inaccurate preoperative diagnosis were discussed.     

Stimulation by prostaglandin E2 of alkaline secretion in the rat duodenum: comparative study with hypertonic NaCl

Possible involvement of increased mucosal permeability in the stimulation by prostaglandin E2 (PGE2) of duodenal HCO3- secretion was investigated in rats. PGE2 (0.3, 1 mg/kg, s.c.) dose-dependently increased HCO3- secretion in the duodenum with a significant elevation of transmucosal potential difference (PD); the PD was increased from -4.5 +/- 0.3 mV to -10.0 +/- 1.5 mV (mucosa negative) at 1 mg/kg. These responses caused by PGE2 were abolished by sacrificing the animals with saturated KCl (i.v.). Although a significant increase of HCO3- output was observed after exposure of the mucosa to 1 M NaCl (0.5 ml), this response was accompanied by a significant reduction of PD and was not abolished after KCl injection. The mucosal permeability determined by Evans blue (1%, i.v.) was not affected by PGE2, while 1 M NaCl markedly elevated the amount of extravasated dye in both the luminal content and the mucosa. Stimulation of HCO3- output by PGE2 was significantly mitigated by ouabain (3 mg/kg, s.c.) or prior exposure of the mucosa to 1 M NaCl. These results suggest that stimulation by PGE2 of duodenal HCO3- secretion is not simply due to the increased mucosal permeability, but depends rather on both the Na/K ATPase activity and the intact perfusion of the organ. The HCO3- response as induced by 1 M NaCl may result from the increased permeability and is accompanied by a marked reduction of PD.