Efficacy of continuous hemodiafiltration for patients with congestive heart failure

BACKGROUND/AIMS: The basic principle of treatment of congestive heart failure is achieving adequate control of preload and afterload through enhancement of cardiac contractility. In severe cases, however, we have usually applied continuous hemodiafiltration (CHDF) as a type of mechanical support. In this study, we investigated hemodynamic changes caused by CHDF in patients with congestive heart failure. METHODS: We treated seven patients with congestive heart failure complicated by multiple organ failure by CHDF over 72 h, during which we measured hemodynamic parameters to determine their changes. RESULTS: Implementation of CHDF resulted in a significant decrease in pulmonary artery occluded pressure and significant increases in cardiac index and left ventricular stroke work index. In addition, 72-hour cumulative water balance was found to be -1,791 +/- 2,119 ml, and systemic vascular resistance index decreased significantly. CONCLUSION: Hemodynamics of patients were improved with CHDF through strict control of preload and consequently tissue oxygen metabolism was improved.     

Shiga-like toxin II derived from Escherichia coli O157:H7 modifies renal handling of levofloxacin in rats

The effect of Shiga-like toxin II (SLT-II) (2 microg/animal), which was derived from Escherichia coli O157:H7, on renal handling of levofloxacin (LVX), a model drug for quinolone antimicrobial agents, was investigated in rats 24 h after intravenous injection. In histopathological examination, acute tubular injury was observed in SLT-II-treated rats, but the glomeruli were not injured. SLT-II significantly increased the steady-state concentration of LVX in plasma to 1.5-fold that of control rats. SLT-II induced significant decreases in the glomerular filtration rate (GFR) and renal clearance (CL(R)) of LVX. SLT-II slightly, but significantly, increased the unbound fraction and decreased renal plasma flow with no change in the extraction ratio of p-aminohippurate. SLT-II significantly increased concentrations of tumor necrosis factor alpha (TNF-alpha) and nitrite and nitrate (NOx) in plasma. The TNF-alpha inhibitor pentoxifylline partly, but significantly, inhibited SLT-II-induced decreases in the GFR and CL(R) of LVX; in contrast, S-methylisothiourea, a selective inhibitor of inducible nitric oxide synthase, did not. Western blotting analysis revealed that SLT-II did not alter the levels of multidrug resistance-associated protein 2 (Mrp2) and P-glycoprotein in kidneys 24 h after injection, assuming the lack of involvement of Mrp2 and P-glycoprotein in SLT-II-induced acute renal tubular injury and renal handling of LVX observed 24 h after SLT-II injection. The present study suggests that SLT-II impairs the renal handling of LVX by decreasing GFR and causing decreased renal plasma flow.     

Physical fitness of lower limb amputees

OBJECTIVE: To investigate the cardiorespiratory endurance of the physical fitness of amputees and able-bodied subjects of the same ages and to demonstrate deterioration of the physical fitness of the amputees. DESIGN: The test subjects were 31 amputees. Eighteen able-bodied persons served as controls. The incremental exercise test was performed to evaluate physical fitness. Sixteen of 31 amputees underwent endurance training by using a cycle ergometer driven by the intact leg, and their physical fitness was evaluated after completion of the endurance training program. RESULTS: The Vo2max, anaerobic threshold, and maximum workload for the amputees were significantly lower than those of the able-bodied group. The equivalent values for the endurance training group before exercise treatment were 18.0, 12.1, and 63.9, respectively. After exercise treatment, these values significantly increased, and there was no significant difference from the able-bodied subjects. CONCLUSIONS: This study showed that the physical fitness of amputees was clearly lower than that of the able-bodied subjects and that the amputees were able to recover from a poorly conditioned status after endurance training.     

Nucleotide sequence of the coat protein coding region of tulip breaking virus

cDNA of tulip breaking virus-tulip (TBV-tulip) RNA was synthesized and cloned inE. coli. One clone that contains a 4.5 kb insert was identified by restriction enzyme analysis, dot immunobinding assay (DIBA), and partial sequencing. Then 1479 nucleotides of the 3-terminus of the clone were sequenced and revealed that the sequence contains one open reading frame (ORF), followed by an untranslated region of 255 nucleotides and a poly(A) tract. The deduced amino acid sequence was found to include the C terminus of the predicted RNA-dependent RNA polymerase and the coat protein. A glutamine-alanine dipeptide was identified as a putative NIa protease cleavage site at the N terminus of the coat protein.The nucleotide sequence data reported in this paper have been submitted to GenBank nucleotide sequence database and have been assigned the accession number X63630.     

用血管活性肠肽预防实验性自身免疫性葡萄膜视网膜炎

背景：血管活性肠肽（VIP）是一种神经肽类物质，目前所知存在于淋巴组织的微循环中，具有显著的抗炎作用。 目的：检测VIP对实验性自身免疫性葡萄膜视网膜炎（EAU）发展的作用。     

Overall open-loop gain of rapidly acting arterial pressure control system in rabbits

Norepinephrine was infused intravenously in two groups of normal, awake rats. In one group local cerebral glucose utilization (LCGU) was measured by the deoxyglucose method (Sokoloff et al. 1977b); in the other group local cerebral blood flow (LCBF) was determined by the iodoantipyrine method (Sakurada et al. 1978). The experiments were performed during a stable state in which the heart rate was reduced between 36% (LCGU experiments) and 27% (LCBF experiments). Norepinephrine infusion reduced LCGU in all 39 structures measured between - 18 and - 37% from control values obtained in a group of normal non-infused rats. The decrease in LCGU was significant (P less than 0.05) in 38 of the 39 structures tested. LCBF was increased but not statistically significantly in most of the structures examined. When the LCGU values of the various structures during norepinephrine infusion were correlated with their corresponding LCBF values, a tight correlation (r = 0.94) was found indicating a close coupling between LCGU and LCBF during norepinephrine infusion. When compared to the relationship between LCGU and LCBF in a normal, non-infused control group, the slope of the regression line was increased significantly (P less than 0.01) by the norepinephrine infusion, indicating a resetting of the coupling mechanism. This means that, at a given metabolic rate, a higher blood flow is needed to perfuse a brain structure during norepinephrine infusion than during control conditions.     

IgM-MONOCLONAL GAMMOPATHY ASSOCIATED WITH MALIGNANT LYMPHOMA WITH RECURRENT PLEURAL EFFUSION

A case of malignant lymphoma (plasmacytold lymphocytic type) with IgM-monoclonal gammopathy is presented. The main site of the lesion was in the lung. The sole clinical manifestation was pleuropulmonary involvement with massive pleural effusion. A clue to the diagnosis was given by cytologlcal and immunocytological examination of pleural aspirates. Subsequent immunological survey of serum protein and a bronchial biopsy confirmed the diagnosis.     

A comparative study of vascular proliferation in brain metastasis of lung carcinomas

Because of the marked vascular proliferation seen in brain metastases of small cell carcinoma of the lung (SCCL), we studied the morphometric and immunohistochemical characteristics of proliferating vessels in metastases from 20 autopsy cases of SCCL with brain metastasis. These were compared with those in surgically resected brain metastases of lung carcinomas, including 6 cases of SCCL, 19 cases of adenocarcinoma and 5 cases of squamous cell carcinoma. Angiogenesis in the tumours was scored by the microscopic angiogenesis grading system (MAGS). The MAGS score for autopsy and surgical metastatic lesions was highest in SCCL. Histologically, many vascular glomeruloid structures were formed in the brain metastases of SCCL, and immunohistochemistry revealed that these lesions were composed of proliferating endothelial cells and pericyte/smooth muscle cells. Immunostaining for basic fibroblast growth factor, a potent angiogenic factor, showed immunoreactivity in the tumour cells, regardless of histological type, and in the surrounding glial cells. Complex autocrine and paracrine phenomena participate in the development of metastatic cerebral lesions with vascular proliferation.