Permeability, morphologic and temperature changes of canal dentine walls induced by Nd: YAG, CO2 and argon lasers

The permeability, temperature and morphologic changes of the wall of the root canal induced by Nd:YAG, CO₂ and argon lasers were studied. The changes were evaluated according to the presence or absence of a smear layer. Root canals of 140 human single-rooted teeth were enlarged using a step-back technique. Permeability was evaluated by the extent of methylene blue dye penetration into the tubules. Temperature changes were measured using a thermovision system, and morphological changes were evaluated by scanning electron microscopy. Laser energy was delivered into the canal by means of a flexible optical fibre or metal tip. There were statistically significant differences in permeability between Iased groups with and without a smear layer in the cervical third of the root canal following lasing. In the middle third of the root canal, all three laser types induced permeability increases in groups with a smear layer. In the apical third, statistically significantly decreases in permeability were observed among C02 laser and Nd:YAG compared with control group (P<0.01). Rises in temperature ranged from a minimum of +10.1 °C (CO₂ laser) to a maximum of +54.8 °C (argon laser). All three laser devices appeared capable of producing a glazed-like surface and craters.     

Clinical significance of the serum levels of the 7S domain of type IV collagen in patients with primary biliary cirrhosis

The serum levels of the 7S domain of type IV collagen were measured with a radio-immunoassay in 42 patients with primary biliary cirrhosis (asymptomatic: n = 28; symptomatic: n = 14), 10 patients with chronic active hepatitis, 10 patients with liver cirrhosis and 10 healthy female controls. Serum levels of the 7S domain of type IV collagen were: 4.28 ng/mL (3.88-4.72 ng/mL; mean and range of mean +/- s.d.) in healthy controls; 5.97 ng/mL (5.07-7.02 ng/mL) in patients with chronic active hepatitis; 8.23 ng/mL (6.40-10.58 ng/mL) in patients with liver cirrhosis; and 6.79 ng/mL (4.76-9.67 ng/mL) in patients with primary biliary cirrhosis. Patients with liver cirrhosis and primary biliary cirrhosis had higher levels of serum 7S domain of type IV collagen than healthy controls (P < 0.001, respectively). Serum levels of the 7S domain of type IV collagen in patients with asymptomatic primary biliary cirrhosis, 5.83 ng/mL (4.55-7.48 ng/mL) were significantly lower than those in symptomatic primary biliary cirrhosis, 9.18 ng/mL (6.53-12.91 ng/mL; P < 0.001). Serum levels of the 7S domain of type IV collagen increased significantly along with advancement of the histological stages of primary biliary cirrhosis. Serum levels of the 7S domain of type IV collagen in the paired sera of eight patients with asymptomatic primary biliary cirrhosis (mean interval 30 months, range 12-48 months) showed significant rises during the intervals (P < 0.05), while serum levels of albumin and total bilirubin did not change significantly during these intervals.(ABSTRACT TRUNCATED AT 250 WORDS)     

Thrombolytic therapy for traumatic unilateral renal artery thrombosis

We report a case of traumatic unilateral renal artery thrombosis that was successfully treated by thrombolytic therapy. The patient was a 17-year-old woman, who had put her left upper abdomen between a wall and the handle of a ground roller when using it. A computed tomography scan with intravenous contrast showed a lack of contrast in the left kidney. Angiography showed complete occlusion of the left renal artery, and the diagnosis was traumatic left renal artery thrombosis. Following angiography, thrombolytic therapy was performed. Urokinase was administered into the left renal artery, and 360,000 units per 1.5 h was required. Thrombus disappeared and flow of left renal artery was observed. Recovery of left renal function was seen on renoscintigraphy. Surgical maneuvers for traumatic renal artery thrombosis are autotransplantation or thrombectomy generally, but we think that thrombolytic therapy following angiography is a less invasive method and saves warm ischemic time.     

Abnormalities of Immunologic Response of Lymphocytes in Patients With Cancer of the Digestive Organs

The lymphocyte functions of 174 patients with cancer of thedigestive organs were studied, with particular reference tothe percentage of T cells bearing receptors for the Fc portionof IgG (T_G cells), phytohemagglutinin (PHA) response of thelymphocytes and the helper activity of T cells. The percentageof T_G cells was 12.18±6.91% (mean±SD) before treatment,exceeding the upper limit of the normal value (8%) in 49.4%of the patients. However, it decreased significantly to 7.98±6.3%after surgical removal of the tumors (r=0.746, P<0.001).The possible correlations of this parameter with two otherswere investigated in order to find a more reasonable parameterfor tumor immunology. An increased percentage of T_G cells anda decreased PHA response of the lymphocytes were found in 5.8%of the cases of stage I, 42.8% of the cases of stage II, 33.3%of the cases of stage III and 48.9% of the cases of stage IVcancer. An increased percentage of T_G cells and a decreasedhelper activity of T cells were found in 20% of the cases ofstage I, 20% of the cases of stage II, 25% of the cases of stageIII and 33.3% of the cases of stage IV. When only gastric cancerpatients were considered, a decreased PHA response of the lymphocytesand an increased percentage of T_G cells were found in 12.5%of the patients with early stages. while this profile was observedin 25.5% of the patients with advanced stages of the disease.An increased percentage of T_G cells and a decreased helper activityof T cells were found in 18.7% of the patients with early stagesand 37.9% of the patients with advanced stages. These findingssuggest that if the three immunological parameters were usedin the above combinations, they might more accurately reflectchanges in immunity with the progress of cancer.     

Embryonal carcinoma of the testis associated with prostate cancer in a 72-year-old man

A 72-year-old Japanese man presented with a painless swollen left scrotal mass with elevated levels of serum alpha-fetoprotein and prostate specific antigen. The patient underwent high orchiectomy under diagnosis and a final pathological examination revealed embryonal carcinoma of the left testis. A systematic needle prostate biopsy under guidance of transrectal ultrasound revealed prostate cancer (Gleason score, 8) on the left lobe (T2aN0M0). Systemic chemotherapy was given for retroperitoneal lymph node metastasis of testicular cancer and hormonal therapy (LH-RH analog) was given for prostate cancer. The patient was well with no evidence of metastasis from the testicular cancer or prostate cancer and with no elevation of serum alpha-fetoprotein or prostate specific antigen 26 months after the orchiectomy.     

HYPERMINERALOCORTICISM WITHOUT ELEVATION OF PLASMA ALDOSTERONE: DEOXYCORTICOSTERONE-PRODUCING ADRENAL ADENOMA AND HYPERPLASIA

Two female patients were admitted for evaluation of hypertension and hypokalaemia. Plasma renin activity was suppressed and plasma aldosterone levels were within the normal value in a 52-year-old woman and below the normal value in the other patient, a 62-year-old woman. Plasma 11-deoxycorticosterone (DOC) levels were as high as 1.13 and 1.47 nmol/l, respectively. Adrenal scintigram and abdominal CT scan clearly showed a right adrenal tumour in the 52-year-old woman. After adrenalectomy plasma DOC level decreased to the normal level of 0.12 nmol/l, and her blood pressure and serum potassium became normal. Abdominal CT scan revealed no finding of adrenal tumour in the older woman. These results indicate that these two patients had hypermineralocorticism with elevation of plasma DOC. One patient had a DOC-producing adrenal adenoma, and the other probably had bilateral adrenal hyperplasia.     

Up-titration of vardenafil dose from 10 mg to 20 mg improved erectile function in men with spinal cord injury

AIM: Vardenafil is a highly selective phosphodiesterase type-5 inhibitor for the treatment of erectile dysfunction (ED). Efficacy of vardenafil has been demonstrated in various ED populations, but that in Japanese patients with spinal cord injury (SCI) has not been assessed. METHODS: This was an open-label, multicenter, flexible dose, 12-week study in patients with ED due to SCI. Following a 4-week observation period, patients received vardenafil 10 mg for 4 weeks, and based on efficacy, tolerability and patient preference, doses for the remaining 8 weeks were decided by investigators. The primary efficacy parameter was erectile function domain score of the International Index of Erectile Function. RESULTS: Ten patients took 10 mg all through the study, while 22 patients took 20 mg after completing 4 weeks' treatment with 10 mg. The erectile function domain score increased from 12.2 at baseline to 25.0 at Last Observation Carried Forward (LOCF) in the former group and from 10.3 to 22.5 in the latter group, respectively. Importantly, there was a 5.0 point increase in erectile function domain score after up-titration in the latter group. Drug-related adverse events were observed in 22% of patients including hot flushes (9%) and headache (6%), but these were transient and mild in intensity. Serious adverse events and adverse events leading to discontinuation of the study drug were not reported. CONCLUSIONS: Vardenafil 10 and 20 mg was well tolerated and improved erectile function in patients with SCI. Of interest, erectile function was further improved by 20 mg in patients who were not sufficiently treated with 10 mg.     

Decreased interleukin-2 receptor β chain expression by peripheral blood lymphocytes in chronic liver disease

To investigate the decrease in natural killer (NK) activity in chronic liver disease, interleukin-2 receptor beta chain (IL-2R beta) expression was assessed by peripheral blood lymphocytes (PBL) using flow cytometry and an IL-2R beta chain-specific mouse monoclonal antibody. The percentage of IL-2R beta chain-positive PBL was significantly decreased in patients with chronic viral hepatitis, liver cirrhosis and hepatocellular carcinoma in comparison with normal controls (P less than 0.01). Among chronic viral hepatitis patients, it was significantly less in those with chronic active hepatitis than in those with chronic persistent hepatitis (P less than 0.05). Two-colour flow cytometry revealed that the IL-2R beta chain was mainly expressed by CD8+ or CD16+ cells in both the controls and the liver disease patients. CD8dull+ cells (NK cells) constituted more than 60% of the CD8+ cells expressing the IL-2R beta chain. Expression of the IL-2R beta chain with CD8 or CD16 was also significantly decreased in chronic liver disease patients compared with controls. In chronic viral hepatitis, there was a significant correlation between NK activity and the percentage of IL-2R beta+ PBL (P less than 0.001, r = 0.916), as well as between NK activity and the percentage of PBL co-expressing both the IL-2R beta chain and CD16 (P less than 0.001, r = 0.850). These findings suggest that decreased expression of the IL-2R beta chain by PBL may result in diminished NK activity in chronic liver disease.     

A longitudinal study of blood pressure,cholesterol and left ventricular muscle volume in children: The Shimane Heart Study

Three hundred and forty-four healthy schoolchildren living in Izumo City, Shimane Prefecture, Japan, were assessed at 3 year intervals from 6 to 15 years, starting in 1978 (Cohort 1) or 1981 (Cohort 2). Tracking indices (Ti) were calculated as follows: Ti = (2x + y - z)/N/0.89, where x, y and z refer to the total number in the same, adjacent and remote trisections, respectively, and N = x + y + z. If Ti > 1, there is positive tracking. For systolic blood pressure (SBP) measurements (except at 6 years old) and serum cholesterol levels, all Ti were greater than 1.0 regardless of the time when tracking was commenced. Tracking indices were slightly greater in the serum cholesterol levels than in the SBP measurements. Left ventricular muscle volume indices (LVMVI) were calculated by echocardiographic measurements. In girls, the LVMVI was larger only in the above-median SBP group at the age of 12 years (P < 0.01), but the LVMVI of the higher SBP (above median) group was larger than in the lower (below median) group at every age in boys; the difference was statistically significant (P < 0.05) at 12 and 15 years of age. Left ventricular mass enlargement may occur in the prehypertensive stage in humans as well as in rats.     

Induction of CINC (interleukin-8) production in rat liver by non-parenchymal cells

The production of interleukin-8 (CINC: cytokine-induced neutrophil chemo-attractant) from different cell populations in the rat liver was studied and cells related to the initiation of CINC production in lipopolysaccharide (LPS)-injected endotoxaemic rats were characterized. Sinusoidal endothelial cells (16.4 ± 10.6 ng/mL) produced significantly higher amounts of CINC in 24 h primary cultures compared with hepatocytes (0.9 ± 0.9 ng/mL; P < 0.05) and Kupffer cells (6.5 ± 5.1 ng/mL; P < 0.05). Lipopolysaccharide, tumour necrosis factor-α (TNF-α), and interleukin-1α (IL-1α) stimulated different liver cell populations to produce CINC; LPS mainly stimulated Kupffer cells, TNF-α stimulated hepatocytes and IL-1α stimulated all three types of cells. Intraperitoneal injection of LPS (4 mg/kg) caused CINC accumulation in non-parenchymal cells of the rat liver within 1 h of injection, as shown by immunohistochemical staining. In contrast, CINC-positive hepatocytes were not seen until 3 h after injection of LPS. Ethanol was not a direct inducer of CINC production by rat hepatocytes in vitro. These findings strongly suggest that non-parenchymal liver cells, including sinusoidal endothelial cells, are the main source of CINC. Our data also suggest that during endotoxaemia, CINC production is initiated by non-parenchymal cells and this is followed by production from hepatocytes.