Long distance air transport by helicopter of a patient with severe head damage

A report of a case of a patient with severe head trauma with pneumonia and cerebral infarction transported by helicopter. An eighty-year-old male was referred to our hospital because of dyspnea after a fall during sightseeing at Hiroshima. He was lucid at first, but, after two days presented restlessness due to brain contusional hemorrhage and edema. Moreover, he developed pneumonia and cerebral infarction during the period of his hospitalization. He was intubated and received central venous routing. While being transported, his consciousness showed moderate disturbance, aphasia and right hemiplegia. His family asked that therapy be continued near his house in Osaka. We selected transport by helicopter because of his bad general condition and because transport time would be much shorter. He was transported by helicopter to Osaka one month after admission. First, he was transported by ambulance to the airport of Hiroshima. He was carried to the helicopter at the airport. An oxygen cylinder was connected to the incubation tube via an ambu bag because direct connection between the oxygen cylinder and the intubation tube was impossible. Just before the take off, O2 saturation was checked by the pulse oximeter of the ambulance. In the helicopter, there were six men; two pilots, two rescue men, one doctor and the patient. Suction was applied only once and there was no trouble during the flight. The weather was fine and the helicopter experienced almost no rolling during the flight. The flight time was only one hour and twenty minutes. The helicopter safely landed at an emergency heliport in Osaka. The patient was carried to a waiting ambulance and transported to the hospital. Total transport time was only two hours and thirty minutes. This is a case showing a helicopter could safely transport a patient with severe brain damage over a long distance in a short time.     

Influence of hypothalamically induced restlessness under fasted and fed conditions on plasma levels of glucose,free fatty acids and total cholesterol

Influence of hypothalamically induced emotional behavior on plasma levels of epinephrine (E), norepinephrine (NE), glucose, cortisol, free fatty acids (FFA) and total cholesterol (T‐C) were examined in cats under both fasted and fed conditions. Restlessness was evoked intermittently for 6 h by electrical stimulation of the anteromedial hypothalamus (AMH). Blood was sampled immediately before, 1 h after and 6 h after the start of stimulation. Both E and glucose levels in the restlessness group increased markedly after 1 h and then tended to decrease after 6 h in fasted and fed states. In the restlessness group the NE level increased after 1 h and further increased after 6 h and cortisol level increased markedly, whether cats were fasted or fed. The FFA level in the fasted restlessness group showed no change while it increased in the fasted control group after 6 h. By contrast, the FFA level in the fed restlessness group significantly increased after 6 h while no change was observed in the fed control group. The T‐C level decreased only under the fasted condition in both restlessness and control groups. These results indicated that AMH‐induced restlessness elicited marked sympatho‐adrenal activation and hyperglycemia whether cats were fasted or fed while the behavior showed a different pattern in the response of plasma FFA between fasted and fed conditions. Copyright © 2001 John Wiley & Sons, Ltd.     

Changes in the leukocyte distribution and surface expression of adhesion molecules induced by hypothalamic stimulation in the cat

Emotions and the neuroendocrine system are known to affect leukocyte distribution. However, there have so far been few reports on the relationship between hypothalamically induced emotional behavior and the endocrine-immune response. We previously reported changes in the leukocyte distribution and adhesion molecules induced by anteromedial hypothalamus stimulation (AH stimulation), which elicits restlessness behaviors in the cat. In this study, we examined ventromedial hypothalamus stimulation (VMH stimulation), which elicits threat behaviors. In addition, the endocrine responses after VMH stimulation were evaluated. VMH stimulation as well as AH stimulation induced elevations of plasma cortisol and epinephrine levels and granulocytosis and lymphopenia. In contrast, VMH stimulation induced only an elevation of plasma norepinephrine and elicited an opposite pattern of CD62L expression on the leukocyte subpopulations. The different endocrine-immunological reactions between VMH stimulation and AH stimulation were thus associated with different types of behavioral responses.     

Intradiploic arachnoid cyst identified by diffusion-weighted magnetic resonance imaging--case report

A 72-year-old woman presented with an intradiploic arachnoid cyst in the occipital intradiploic space which was found incidentally by magnetic resonance (MR) imaging. Computed tomography revealed a widened diploic space and thinning of the inner and outer tables of the occipital bone. The cyst appeared as isointense to the cerebrospinal fluid on both T1- and T2-weighted images. The differential diagnosis of intradiploic epidermoid cyst could be excluded because the lesion was low intensity on diffusion-weighted MR images. Arachnoid cyst is a benign lesion, so exploratory surgery should be avoided unless the cyst is symptomatic. Diffusion-weighted MR imaging is an effective modality to distinguish diploic epidermoid cysts from arachnoid cysts.     

Single sysem ectopic ureters and ureteroceles associated with dysplastic kidney

Eight children forming an uncommon subgroup of renal obstructive dysplasia are presented. Each child had a nonfunctioning dysplastic kidney with a single collecting system with ectopic ureteral insertion and/or ureterocele. Five of the children had classic multicystic dysplastic kidneys, one had they hdyronephrotic type of multicystic dysplasia kidney had two had hypoplastic kidneys. Other significant medical problems in 5 of the 8 children (63%Z) included VACTERL association, congenital heart diseaise and other genitourinary malformations. Unlike some children with unilateral multicystic dysplasia kidney, this subgroup of children ahs an increased risk of infection. The must be correctly identified on imaging so that tailored clinical management decisions can be made and associated anomalies detected.Presented at the 1990 meeting o the RSNA     

Presence of adipose differentiation-related protein in rat meibomian gland cells

Adipose differentiation-related protein (ADRP) is an intrinsic lipid storage protein found in lipid droplets of different type of cells. ADRP has been recognized to be a specific marker of lipid accumulation and a marker of differentiated adipocytes. The purpose of this study was to determine whether ADRP was present in the cells of the meibomian gland. The expression of the mRNA of ADRP was determined by RT-PCR and Northern blot analysis of the meibomian gland and other rat tissues. A newly generated polyclonal antibody against rat ADRP was used for Western blot analysis and immunohistochemical staining to determine whether ADRP was expressed in the rat meibomian gland. Meibomian gland acinar cells were isolated to determine when ADRP was expressed during cell differentiation in vitro. Northern blot analysis and Western analysis showed that ADRP was expressed in the meibomian gland. Immunoreactivity to ADRP was observed in the lobules of acinar cells in the meibomian gland, and was preferentially located adjacent the vacuolated cytoplasm. In culture, the meibocytes began to store lipid droplets in the cytoplasm as they became confluent, and the immunoreactivity for ADRP was found at the margins of the oil droplets. Our results suggest that ADRP can serve as a new marker for the identification of differentiated meibocytes containing lipid droplets.     

The effects of hyperventilation upon spinal dorsal horn neuronal single-unit activities under nitrous oxide anesthesia

BACKGROUND: The purpose of this study is to investigate the effects of hyperventilation upon spinal dorsal horn neuronal single-unit activities under nitrous oxide anesthesia. METHODS: Eight decerebrated spinal cats with laminectomy were maintained with oxygen and pancuronium bromide. Following the control period of normocapnia, 50% nitrous oxide was administered for 30 minutes after a hypocapnia period of 20-25 mmHg for 20 minutes. The recoveries of activities followed with normocapnia and pure oxygen administration. The changes of spontaneous and evoked activities by the pinching were investigated every 5 minutes after control study. RESULTS: Inhalation of 50% nitrous oxide suppressed the WDR neuronal activities and with hyperventilation the suppressions significantly increased. CONCLUSIONS: These results were compatible with clinical reports on the effectiveness of hyperventilation as a maintenance method under N2O anesthesia.     

Renoprotective effects of telmisartan in the 5/6 nephrectomised rats.

The purpose of this study was to investigate the renoprotective effect of telmisartan on the advanced stages of nephropathy in rats with 5/6 nephrectomy (5/6 Nx). Telmisartan was orally administered for 12 weeks to rats that previously underwent 5/6 Nx or sham operations. After completion of the administration period, the degree of renal injury was examined histopathologically using indices of glomerulosclerosis and lesions of the renal tubule and interstitium. An immunohistochemical staining for transforming growth factor-beta (TGF-beta1) was also performed. The suppression of urinary protein was statistically significant in surviving animals dosed with telmisartan. The enalapril group's urinary protein was also significantly suppressed for these same parameters in surviving animals. Histopathologically, telmisartan significantly decreased the progression of glomerulosclerosis and the interstitial cell infiltration at all doses tested. As assessed by immunohistochemical staining the TGF-beta1 reactivity in the glomerular tissue tended to decrease in the telmisartan group when compared to the vehicle group. Thus, telmisartan ameliorates the progressive nephropathy in the remaining kidney after 5/6 Nx by non-haemodynamic as well as antihypertensive actions of the drug.