Incidence and duration of hoarseness following endotracheal intubation

The incidence and duration of hoarseness following tracheal intubation with general anesthesia were studied retrospectively from November 1998 to October 2000 in postanesthetic clinic of Nara Medical University. Total number of patients was 3977 and 37.1% of them complained of hoarseness. Most of there patients recovered within three days after surgery but in 4.2% the hoarshness persisted over ten days and in 0.7% persisted over one month after surgery. Most of these persistent hoarseness were considered to have originated from surgical procedures (such cervical, pulmonary, cardioaortic operation, etc.) and those following only tracheal intubation recovered within two months after surgery. The hoarseness decreased the satisfactory level for anesthesia in 1.0% of total patients and 12.8% of patients with persistent hoarseness. We consider that preoperative explanation and postoperative communication by anesthesiologists are important.     

Preserved IFN-alpha production of circulating Valpha24 NKT cells in primary lung cancer patients

Human Valpha24 NKT cells bearing an invariant Valpha24JalphaQ antigen receptor, the counterpart of murine Valpha14 NKT cells, are activated by a specific ligand, alpha-GalCer, in a CD1d-dependent manner. Here, we demonstrate decreased numbers of circulating Valpha24 NKT cells in patients with primary lung cancer compared to healthy volunteers. However, Valpha24 NKT cells and DCs from lung cancer patients were functionally normal, even in the presence of tumor. Furthermore, levels of Valpha24 NKT cells in surgically resected lung tissue appeared to be equivalent to those of Valpha14 NKT cells in the mouse lung. Levels of Valpha24 NKT cells in the tumor tissue itself were increased about 2.5 times. Administration of alpha-GalCer-pulsed DCs expanded Valpha14 NKT cells in the lung more than 10 times, and the increased levels were sustained for 1 week. This may explain the previous finding that alpha-GalCer-pulsed DCs exerted strong antitumor activity in mouse lung tumor metastatic models. The potential use of alpha-GalCer-pulsed DCs for immunotherapy aimed at activating endogenous Valpha24 NKT cells in the lung of cancer patients is discussed.     

Novel chondroitin sulfate-binding cationic liposomes loaded with cisplatin efficiently suppress the local growth and liver metastasis of tumor cells in vivo

An increased level of chondroitin sulfate (CS) expression on the cell surface is often associated with malignant transformation and the progression of tumor cells. In this study, CSs expressed on highly metastatic tumor cells were used as a target for the selective delivery of anticancer drugs by polyethylene glycol (PEG)-coated liposomes that contained a new cationic lipid 3,5-dipentadecycloxybenzamidine hydrochloride (TRX-20). We found that PEG-coated TRX-20 liposomes (TRX-20 liposomes) bound preferentially to certain CSs, such as CS B, CS D, and CS E, whereas PEG-coated liposomes lacking TRX-20 showed no significant binding to any of the glycosaminoglycans tested. In vitro, TRX-20 liposomes, but not plain PEG liposomes, avidly bound to and were readily internalized by highly metastatic tumor cells such as LM8G5 and ACHN cells, which express large amounts of CS on the cell surface. When TRX-20 liposomes were loaded with cisplatin, they effectively killed the CS-expressing tumor cells in vitro, whereas cisplatin-PEG liposomes lacking TRX-20 were totally ineffective. When injected systemically, TRX-20 liposomes preferentially accumulated in the liver and in solid s.c. LM8G5 tumors. Therapeutic experiments in mice bearing a s.c. LM8G5 tumor revealed that cisplatin-loaded TRX-20 liposomes were significantly more effective in reducing the local tumor growth than cisplatin-loaded plain PEG liposomes or free cisplatin. Furthermore, the cisplatin-loaded TRX-20 liposomes markedly suppressed metastatic spreading of LM8G5 tumor cells to the liver, significantly increasing the survival time of the tumor-bearing mice. These results demonstrate that the CS-targeted delivery of anticancer drugs by novel cationic liposomes represents a potentially useful strategy to prevent the local growth and metastasis, particularly to the liver, of tumor cells that have enhanced expression of CS.     

Report based on fiscal 2000 diagnostic x-ray equipment questionnaire survey(conditions of radiography)

X-ray equipment has seen advances in inverters and the digitalization of reception systems. The X-ray Systems Study Group, in order to examine changes in the conditions of radiography, including pediatric radiography, variations in shortest irradiation time, and standardization of the conditions of radiography, carried out investigative research using a questionnaire survey that was sent to 400 facilities. The recovery rate was 33%. In terms of the reception system, half of the general radiography systems were using computed radiography (CR). Seventy percent of respondents used an intensifying screen and film(S EF)in stomach double-contrast radiography. About 80% used digital radiography (DR) and digital subtraction angiography (DSA) in aorta abdominalis angiography. At least 70% of high-voltage generators were of the inverter type. The conditions of radiography were not greatly influenced by changes in reception systems and X-ray equipment. Many pediatric radiographies were carried out by radiological technologists. We consider it useful to conduct such survey investigations.     

Expansion of Lung Vα14 NKT Cells by Administration of α-Galactosylceramide-pulsed Dendritic Cells

NKT cells, a novel murine lymphoid lineage bearing an invariant T cell receptor encoded by Vα14 and Jα281 gene segments, recognize a specific ligand glycolipid, α-galactosylceramide (α-GalCer) in a CDld-dependent manner. Recent research has revealed that activated Vα14 NKT cells have dramatic antitumor effects against a wide variety of tumor cell lines in vivo and in vitro. Here, we demonstrate strong in vivo antitumor effects brought about by treatment with α-GalCer-pulsed dendritic cells in comparison with in vitro -activated Vα14 NKT cells. Furthermore, we show a significant expansion of endogenous Vα14 NKT cells in the lung following the administration of α-GalCer-pulsed dendritic cells. The feasibility of immunotherapy with α-GalCer-pulsed dendritic cells is discussed.     

Effect of intracarotid infusion of etoposide with angiotensin II-induced hypertension on the blood-brain barrier and the brain tissue

Summary This study investigated the effects of the intracarotid infusion of etoposide in combination with angiotensin 11 (AT 11)-induced hypertension on the blood-brain barrier (BBB) and brain tissue in rats. Eighty rats were divided into five groups: Group 1, intravenous infusion of AT 11 to increase arterial blood pressure; Group 2, intracarotid infusion of etoposide at 22.5 mg/m² for 10 minutes; Group 3, intracarotid infusion of etoposide at 75.0 mg/m² for 10 minutes; Group 4, intracarotid infusion of etoposide at 75.0 mg/m² for 20 minutes; Group 5, intracarotid infusion of etoposide at 75.0 mg/m² for 10 minutes with AT 11-induced hypertension. Evans blue staining of the brain was used as a monitor of BBB disruption. Mean arterial blood pressure over the experimental period in Group 1 increased from 86.3 ± 1.3 mmHg (mean ± SEM) to 139.0 ± 2.4 mmHg, and Group 5 from 85.9 ± 1.8 mmHg to 137.3 ± 2.4 mmHg. None of the animals in Group 1 and 2 showed any obvious neurological change, while all the animals in Group 3, 4 and 5 exhibited diminished activity as their sole neurological change throughout the course of the experiment. Slight evidence of BBB disruption was seen in only 25% of the animals in Group 1. Significant BBB disruption was found in the animals in Group 2, 3, 4 and 5. No histological change was observed in any animal in Group 1 and 2. Demyelination, cerebral edema, and neuronal change on the infused hemisphere were observed in half of the animals in Group 3, 4 and 5, but no marked difference was observed among the three groups.At II-induced hypertension is unlikely to have an adverse effect by itself on the BBB and brain tissue. However, intracarotid infusion of high-dose etoposide is capable of producing BBB disruption and irreversible neuronal damage by itself irrespective of infusion rate. Modification of BBB and neuropathological change in case of intracarotid infusion of etoposide with AT 11-induced hypertension primarily caused by etoposide itself and not by the AT II-induced hypertension.     

Required thermal environments for the quadriplegic persons: Analyses of questionnaires and experiments on their daily life

A physically disabled person often has additional disabilities on adaptation to the thermal environment. Since 1976, our group has carried out a series of studies to find required thermal conditions for disabled persons on several typical disabilities. This paper reports on the results of our latest questionnaire and experiments on daily thermal environment for quadriplegic persons. Among 292 quadriplegic persons with valid questionnaire, 184 (63%) were fully paralyzed. Nearly 90% of these and 60% of partially paralyzed patients were dissatisfied with the thermal environment and sweating. Several suggestive differences were found according to the broken positions of vertebrae. The results of 48 hours of field measurements on three quadriplegic subjects are compared with those obtained from questionnaire.     

UFD2a mediates the proteasomal turnover of p73 without promoting p73 ubiquitination

p73 protein level is kept extremely low in mammalian cultured cells and its stability may be regulated by not only the ubiquitin/proteasome-dependent proteolysis but also through other unidentified mechanisms. Here, we found for the first time that p73 is physically as well as functionally associated with the U-box-type E3/E4 ubiquitin ligase UFD2a. The immunoprecipitation experiments demonstrated that this interaction is mediated by the COOH-terminal region of p73alpha containing SAM domain. During the cisplatin-induced apoptosis in SH-SY5Y neuroblastoma cells, p73alpha accumulated at a protein level, whereas the endogenous UFD2a was significantly reduced in response to cisplatin. Ectopic expression of UFD2a decreased the half-life of p73alpha in association with a significant inhibition of the p73alpha-mediated transactivation as well as proapoptotic activity. Downregulation of endogenous UFD2a by antisense strategy resulted in a remarkable accumulation of p73alpha. Unexpectedly, UFD2a-mediated degradation of p73alpha was sensitive to the proteasomal inhibitor, however, UFD2a did not affect the ubiquitination levels of p73alpha. Taken together, our present findings imply that UFD2a might promote the proteasomal turnover of p73 in a ubiquitination-independent manner, and also suggest that UFD2a might play an important role in the regulation of cisplatin-induced apoptosis mediated by p73.     

Pharmaceutical terms reflecting the change in practice in Japan

The implementation of Iyaku Bungyo, the changed regulations for drug distribution and the proposed change of pharmacy education from a four-year program to a six-year program are rapidly changing the practice of pharmacy. However, pharmacists' activities still remain at the level of simple dispensing and selling of drugs. Also, the terms that describe the essence of pharmacists' activities, such as services in patient care areas are still unclear. In order to solve and improve the problem of terminology for pharmacists' activities the use of terms related to pharmacists' services were examined in historical context. It was found that the terms "Rinsho yakugaku" and "Iryo yakugaku" have been used as having a similar meaning. Further, the term "Iryo yakugaku" was used to denote the comprehensive scope of pharmacists' services including "Rinsho yakugaku". It was verified that "Rinsho yakugaku" is a valid translation for "clinical pharmacy". "Iryo yakugaku" has a more comprehensive translation than "pharmaceutical care", therefore, it appears that "Iryo yakugaku" is a suitable translation for "pharmaceutical services". Hence, we proposed "Iryo yakugaku" as the English translation for "pharmaceutical services" and "Chiryo yakugaku" as the Japanese translation for "pharmaceutical care". There is a need, however for further clarification and definition of pharmacists' activities.     

Nitroglycerin to relax the uterus during cesarean delivery for the low birthweight baby

BACKGROUND: The uterus at premature birth being thick and sensitive, we applied nitroglycerin (NTG) to relax the uterus during cesarean delivery for the low birthweight baby. METHODS: Twelve parturients of impending premature birth and nine of severe intoxication were included. General anesthesia was induced with thiamylal, and maintained with 5% inhaled sevoflurane. NTG was injected in an intermittent dose of 500 microg. The relative hardness of the uterus at delivery was evaluated by obstetricians in four ranks of categories. RESULTS: The mean gestation period was 27.4 weeks (24 weeks at the minimum-33 weeks at the maximum) and the mean birthweight was 986 g (561-1518 g). The mean time elapsed from induction of anesthesia to delivery was 8.3 min (2-14 min) while NTG was injected for the mean 1.8 times that reflected a total dose of 900 microg (500-1500 microg). The mean endtidal concentration of sevoflurane at delivery reached 3.8% (3.4-4.3%). The uterus was evaluated as "very soft" in 15 out of 21 cases, and all babies were extracted easily without injury through the lower J-shaped section of the uterus. The mean Apgar score was 2.9 points at 1 minute and 6.3 points at 5 minutes. No adverse effect of NTG on the mothers or babies was noticed. CONCLUSIONS: NTG relaxes the uterus effectively and facilitates cesarean delivery for the low birthweight baby.