Effects of diabetes on nitric oxide-mediated relaxations in male rat corpus cavernosum smooth muscle

INTRODUCTION: We evaluated the effects of diabetes on nitric oxide-mediated relaxations and nitric oxide synthase activity in male rat corpus cavernosum smooth muscles. METHODS: Eight-week-old male rats were assigned to three groups: control (injected with the vehicle), DM (diabetes mellitus, induced by injection with 65 mg/kg streptozotocin), and TES (testosterone, testosterone supplemented after induction of diabetes). After 8 weeks, corpus cavernosum smooth muscle strips were mounted in an organ bath for isometric tension recordings. Electrical field stimulation (EFS, 2-ms pulse duration, 0.3-20 Hz and 3 s train) was applied to the strips precontracted with 30 microM phenylephrine. The microdialysis probe was inserted into the strip, and Krebs-Henseleit solution was perfused into the probe. The dialysate during EFS was collected, and the amount of NO(-)(2)/NO(-)(3) (NOx) released in the dialysate was measured by the Greiss method. Sodium nitroprusside (0.1 nM to 10 mM) and carbachol (1 nM to 10 mM) were cumulatively added to the strips precontracted with 30 microM phenylephrine. RESULTS: EFS caused frequency-dependent relaxations and NOx releases of the strips. Pretreatment with N(omega)-nitro-L-arginine (100 microM) and tetrodotoxin (1 microM) completely inhibited the relaxations and NOx releases. The maximum relaxation was significantly greater in the DM group than in the control or TES group. The release of NOx was significantly greater in the DM group than in the control or TES group. Sodium nitroprusside, the endothelium-independent vasodilator, relaxed the tissues in all three groups. There were no significant differences among control, DM and TES groups in the maximum relaxation to sodium nitroprusside. CONCLUSION: The present data suggest that diabetes enhances nitric oxide synthase activity and nitric oxide-mediated relaxations in the male rat corpus cavernosum by the reduced testosterone level in the diabetic animals.     

Long-term results of thoracoabdominal bypass graft for atypical coarctation of the aorta

Seven patients with atypical coarctation of the aorta were treated with a long thoracoabdominal bypass graft. One of them had a right renal bypass at the same time. One patient who had undergone a patch angioplasty 4 years previously died of bleeding at the time of surgery. Five out of 6 patients who survived the operation have remained normotensive and free of symptoms for up to 12 years, with an average followup period of 4 years. One patient died 3 1/2 years postoperatively from rupture of a pseudoaneurysm. Our experience indicates that atypical coarctation of the elongated type can be treated satisfactorily by the long thoracoabdominal bypass graft. If associated lesions of renal stenosis are present, renal revascularization is also necessary to overcome hypertension.

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Résumé Chez 7 malades atteints de coarctation aortique atypique, nous avons réalisé un long bypass thoracoabdominal. Chez l'un d'entre eux, un bypass rénal droit a été fait en même temps. Un malade, qui avait eu une angioplastie d'élargissement 4 ans auparavant, est mort d'hémorragie peropératoire. Sur les 6 survivants, 5 sont restés sans symptome et avec une tension artérielle normale pendant une moyenne de 4 ans (maximum 12 ans de follow-up). Un malade est mort après 3 1/2 ans de rupture d'un faux anévrisme. Notre expérience montre que les longues coarctations atypiques peuvent être traitées de façon satisfaisante par un long bypass thoraco-abdominal. S'il existe des sténoses associées des artères rénales, il faut en même temps revasculariser le rein pour corriger l'hypertension.

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Presented at the XXVIIth Congress of the Société Internationale de Chirurgie, Kyoto, Japan, September 3–8, 1977.     

Heart preservation with metabolic inhibitor,hypothermia, and hyperbaric oxygenation

The effect of metabolic inhibitor, hypothermia (4°C) and hyperbaric oxygenation (3 atm) on prolonging survival of the canine anoxic heart has been evaluated. Donor hearts were obtained from small mongrel dogs by giving the pre-cooled perfusate of 2 per cent magnesium sulfate (MgSO₄), 5 per cent low molecular weight dextran (LMWD) and 2 per cent glucose into the right atrium. Excised hearts were kept at 4°C in a hyperbaric chamber pressurized to 3 atm. After 18 to 48 hours the preserved hearts were transplanted to the neck of recipients by the methods of Marcus. The viability of the preserved hearts were evaluated with functional, biochemical and histologic parameters. Of 29 hearts preserved for 18 to 36 hours, 27 hearts returned to a strong coordinated beat and could maintain function for over 4 hours. Of 5 hearts preserved for 48 hours, 4 showed a coordinated ventricular beat, however, failed to maintain cardiac work over 4 hours. The hearts with 18 to 36 hours storage showed no significant abnormalities on myocardial metabolism and morphology as compared to the control group of the immediately transplanted hearts. The protective action of magnesium is probably related to a number of factors, including metabolic depression and stabilizing effect on membrane permeability of cells to potassium, which would tend to maintain a more normal membrane potential and sub-cellular particles. These studies indicate that viability of the mammalian anoxic hearts can be extended to 36 hours by the combined use of metabolic blockade, hypothermia and hyperbaria suggesting a practical approach to procurement and preservation of cadaver organs.     

Mass screening for prostate cancer in patients with end-stage renal disease: a comparative study

OBJECTIVE: To determine the usefulness of prostate-specific antigen (PSA) screening for prostate cancer in patients with end-stage renal disease (ESRD), as although serum PSA is effective in the early detection of this cancer in the general population, there are few reports of its utility in patients with ESRD. PATIENTS AND METHODS: Blood samples were obtained for PSA screening from April 2002 to September 2003; 1250 men with ESRD aged >50 years were compared with 1007 healthy control men aged >55 years, all in Kumamoto Prefecture, Japan. All men with a serum PSA level of >4.0 ng/mL were categorized as PSA-positive and were further assessed, including a prostate biopsy. RESULTS: There was a statistically significantly greater increase in PSA level with age in the ESRD group than in the healthy controls. The rate of cancer detection among men with a PSA level of >10 ng/mL was significantly higher in patients with ESRD than in healthy controls. Thirteen patients with ESRD and five healthy control men were finally diagnosed with prostate cancer. CONCLUSION: The serum PSA level was slightly higher and the incidence of prostate cancer at higher PSA levels appeared to be greater in men with ESRD than in healthy controls. The findings of this large study suggest that PSA screening is useful for the diagnosis of prostate cancer in these patients.     

Trueness and precision of digital impressions obtained using an intraoral scanner with different head size in the partially edentulous mandible

Purpose

It remains unclear whether digital impressions obtained using an intraoral scanner are sufficiently accurate for use in fabrication of removable partial dentures. We therefore compared the trueness and precision between conventional and digital impressions in the partially edentulous mandible.

Immunohistochemical studies of mucin antigens in pancreas and intrahepatic bile-duct tumors

Our previous studies of pancreatic and intrahepatic bile-duct tumors revealed that MUC2 mucin (“secretory mucin”, detected by a polyclonal antibody, anti-MRP) was highly expressed in intraductal papillary-mucinous tumors of the pancreas (IPMTs) and bile duct cystadenocarcinomas of the liver (BDCs) with expansive growth pattern and favorable prognosis, whereas it was rarely or not expressed in invasive ductal carcinomas of the pancreas (IDCs) and cholangiocarcinomas of the liver (CCs) with invasive growth pattern and poor prognosis. In contrast, MUC1 mucin (“membrane-bound mucin” detected by the monoclonal antibody, DF3) was rarely or not expressed in IPMTs and BDCs, but was always expressed in IDCs and CCs (Cancer 71:2191—2199, 1993;Int J Cancer 55:82—91, 1993). The results of these studies suggest that the difference in the expression of MUC1 and MUC2 mucins is a useful indicator of malignant potential in neoplasms of the pancreas and intrahepatic bile duct. This article is a review of our previous studies described above. In addition, we present longer-term follow-up data for the cases reported in our previous studies as well as demonstrating pathological prognostic factors, such as lymph node status, lymphatic infiltration, and perineural invasion. We also examined several additional cases of IPMTs and analyzed the same prognostic factors. We could confirmed the findings of our previous studies, and found that most IPMTs and BDCs with a MUC1(?) and MUC2(+) expression pattern showed less aggressive pathological factors than most IDCs and CCS with a MUC1(+) and MUC2(?) expression pattern.     

A case of brain ischemia presenting spectacular shrinking deficit in adult-onset Still's disease associated with antiphospholipid antibody syndrome]

A 63-year-old man presenting remittent fever and multiple arthralgia was diagnosed as adult-onset Still's disease (AOSD), and started with prednisolone treatment. However, he suddenly developed loss of consciousness, paresis of the right upper extremity and aphasia shortly after the treatment. We detected an increased signal of brain tissue lactate at the branch territory of left middle cerebral artery by MR spectroscopy (MRS), but no lesions by diffusion-weighted nor T2-weighted MRI, suggesting acute brain ischemia of embolic mechanism. Most of the symptoms resolved in a couple of hours after the onset, showing spectacular shrinking deficit (SSD). The patient also revealed complication of antiphospholipid antibody syndrome (APS), which may be associated with ischemic event. This is the first case of acute brain ischemia with SSD, which occurred in AOSD with APS. MRS was superior to diffusion MRI in detection of acute brain ischemia.     

Risk factors for surgical site infection following spinal instrumentation surgery

Background

In spinal instrumentation surgeries, surgical site infection (SSI) is one of the complications to be avoided. However, spinal instrumentation surgeries have a higher rate of SSI than other clean orthopedic surgeries. The purpose of this study was to investigate the risk factors for SSI following spinal instrumentation surgeries and contribute to the prevention of SSIs by identifying high-risk patients.