Effect of Taurine on Hemodiafiltration in Patients With Chronic Heart Failure

Taurine, an important factor in the living body, is essential for cardiovascular function and development and function of skeletal muscle, retina and central nervous system. In the present study, its effect on cardiovascular function was specifically taken into consideration. In hemodiafiltration (HDF) patients, the effect of taurine on patients with chronic heart failure (CHF), in whom dry weight was difficult to control, was evaluated. All patients who were subjected to regular HDF for 4 h three times per week at Joban hospital were included in this study. Patients with chronic heart failure, in whom dry weight was difficult to control (N = 4), were included in the evaluation of clinical status. X‐ray and echocardiography were determined before and after taurine treatment. Almost all patients were taking nitric acid, warfarin, anti‐platelet agents and vasopressors. Because vital signs were unstable in chronic heart failure, all cases withheld antihypertensive drugs during HDF. For unstable vital signs during HDF, pulmonary congestion was chronically recognized. After taurine was started, vital signs stabilized and lowering of dry weight was possible. In addition, X‐ray and cardiac diastolic failure on echocardiography improved. Taurine was effective for CHF patients on HDF in whom dry weight was difficult to control in spite of various medications.     

Conservative treatment of ruptured vertebrobasilar dissecting aneurysm

Ruptured vertebrobasilar dissecting aneurysm is usually treated surgically because rebleeding negatively affects outcome. However, the risk of rebleeding decreases markedly once several hours have passed from the initial bleeding. Moreover, surgery-related complications are not rare. We describe seven patients with ruptured vertebrobasilar dissecting aneurysm. To prevent rebleeding during the acute stage, we treated all seven patients conservatively with fentanyl instead of emergency surgery. During the follow-up period (mean 20 months), no patient suffered rebleeding. Conservative treatment with fentanyl administration may be a good option for management of ruptured vertebrobasilar dissecting aneurysm during the acute stage.     

Totally laparoscopic colectomy with intracorporeal anastomosis achieved using a laparoscopic linear stapler: experience of a single institute

Purpose  

Laparoscopic colonic surgery is now widely accepted. We assessed the safety and effectiveness of using a total intracorporeal surgical strategy to perform intracorporeal functional end-to-end anastomosis with an endoscopic linear stapler to treat colon cancer.     

Increased insulin sensitivity and hypoinsulinemia in APS knockout mice

A tyrosine kinase adaptor protein containing pleckstrin homology and SH2 domains (APS) is rapidly and strongly tyrosine phosphorylated by insulin receptor kinase upon insulin stimulation. The function of APS in insulin signaling has heretofore remained unknown. APS-deficient (APS(-/-)) mice were used to investigate its function in vivo. The blood glucose-lowering effect of insulin, as assessed by the intraperitoneal insulin tolerance test, was increased in APS(-/-) mice. Plasma insulin levels during fasting and in the intraperitoneal glucose tolerance test were lower in APS(-/-) mice. APS(-/-) mice showed an increase in the whole-body glucose infusion rate as assessed by the hyperinsulinemic-euglycemic clamp test. These findings indicated that APS(-/-) mice exhibited increased sensitivity to insulin. However, overexpression of wild-type or dominant-negative APS in 3T3L1 adipocytes did not affect insulin receptor numbers, phosphorylations of insulin receptor, insulin receptor substrate-1, or Akt and mitogen-activated protein kinase. The glucose uptake and GLUT4 translocation were not affected by insulin stimulation in these cells. Nevertheless, the insulin-stimulated glucose transport in isolated adipocytes of APS(-/-) mice was increased over that of APS(+/+) mice. APS(-/-) mice also showed increased serum levels of leptin and adiponectin, which might explain the increased insulin sensitivity of adipocytes.     

Effect of carteolol hydrochloride on ocular blood flow dynamics in normal human eyes

PURPOSE: The effect of topical 2% calteolol hydrochloride on the ocular blood flow dynamics in normal human eyes was studied. MATERIALS AND METHODS: Ten healthy volunteers were studied using color Doppler imaging and scanning laser Doppler flowmetry. In the first experiments, one eye received 30 microliters of 2% carteolol hydrochloride twice daily for 7 days and the fellow eye a placebo in a randomized masked manner. The blood flow velocity of the central retinal artery, the ophthalmic artery, and the short posterior ciliary artery, the blood flow volume of the peripapillary retina (PPR), intraocular pressure (IOP), ocular perfusion pressure (OPP) and pulse rate (PR) were measured before treatment, 2 hours after the initial instillation, and after the last instillation on the 7th day. In the control experiments, 30 microliters of placebo was instillated in both eyes, and the above parameters were measured according to the same time schedule as in the first experiments. RESULTS: In the carteolol-treated eyes, the systolic maximum (p = 0.012) and diastolic minimum (p = 0.019) blood flow velocities of the ophthalmic artery, and the blood flow volume of the superior (p = 0.003), central (p = 0.001) and inferior (p = 0.000) PPR showed significant increases in the first experiments compared with the control experiments. IOP and OPP in both eyes showed significant reduction in the first experiments compared with the control study. CONCLUSION: These results indicated that topical carteolol hydrochroride increases the blood flow of the intraorbital microcirculation and PPR.     

An autopsy case of congenital complete heart block in a newly born of a mother with systemic lupus erythematosus

Summary An autopsy case of congenital atrioventricular (AV) heart block is described. A newborn infant of a mother with systemic lupus erythematosus died 10 h after birth. Autopsy revealed hematoxylin bodies in the AV node, central fibrous body, and fibrous annulus of the heart. Also, immunoglobulin G (IgG) localization in the hematoxylin bodies was demonstrated by an immunoperoxidase technique. It is suggested that IgG or immune complexes crossed the placenta and that the immune deposition directly injured the cardiac conduction system, causing AV block.     

A qualitative and quantitative analysis of rhythmic activities during a mental task and sleep spindles

The frequency, configuration, and distribution of sleep spindles are similar to some of the rhythmic activities seen during task performance. In the present study, the relationship between rhythmic activities during sleep and arithmetic addition was investigated in male university students with (n = 10) and without (n = 10) frontal midline theta activity (Fmtheta). Electroencephalograms (EEGs) during addition in both groups were compared at frontal and central areas on three consecutive days. Polysomnograms were recorded at the same regions on four consecutive nights for each group. The amount of theta rhythm during a mental task (Fmtheta) and in nocturnal sleep at Fz and Cz electrodes was greater for the Fmtheta group than for the non-Fmtheta group, while the amount of beta rhythm at both sites was smaller in the Fmtheta group than in the non-Fmtheta group. There were no differences between the groups in the amount of alpha rhythm at either site. The frequency of alpha rhythm at Fz and Cz in both situations was slower for the Fmtheta group than for the non-Fmtheta group, but there were no differences in the frequency of theta and beta rhythms between the groups at either site. These results suggest that rhythmic activities during a mental task and in sleep may correlate with each other.     

Correction of nonuniform attenuation and image fusion in SPECT imaging by means of separate X-ray CT

Improvements in image quality and quantitation measurement, and the addition of detailed anatomical structures are important topics for single-photon emission tomography (SPECT). The goal of this study was to develop a practical system enabling both nonuniform attenuation correction and image fusion of SPECT images by means of high-performance X-ray computed tomography (CT). A SPECT system and a helical X-ray CT system were placed next to each other and linked with Ethernet. To avoid positional differences between the SPECT and X-ray CT studies, identical flat patient tables were used for both scans; body distortion was minimized with laser beams from the upper and lateral directions to detect the position of the skin surface. For the raw projection data of SPECT, a scatter correction was performed with the triple energy window method. Image fusion of the X-ray CT and SPECT images was performed automatically by auto-registration of fiducial markers attached to the skin surface. After registration of the X-ray CT and SPECT images, an X-ray CT-derived attenuation map was created with the calibration curve for 99mTc. The SPECT images were then reconstructed with scatter and attenuation correction by means of a maximum likelihood expectation maximization algorithm. This system was evaluated in torso and cylindlical phantoms and in 4 patients referred for myocardial SPECT imaging with Tc-99m tetrofosmin. In the torso phantom study, the SPECT and X-ray CT images overlapped exactly on the computer display. After scatter and attenuation correction, the artifactual activity reduction in the inferior wall of the myocardium improved. Conversely, the incresed activity around the torso surface and the lungs was reduced. In the abdomen, the liver activity, which was originally uniform, had recovered after scatter and attenuation correction processing. The clinical study also showed good overlapping of cardiac and skin surface outlines on the fused SPECT and X-ray CT images. The effectiveness of the scatter and attenuation correction process was similar to that observed in the phantom study. Because the total time required for computer processing was less than 10 minutes, this method of attenuation correction and image fusion for SPECT images is expected to become popular in clinical practice.     

Appearance of frontal midline theta activity in patients with generalized anxiety disorder

The appearance of frontal midline theta activity (Fmθ), recognized as distinct EEG theta rhythm in the frontal midline area during performance of a mental task, reflects feelings of relief from anxiety in humans. In the present study, EEGs were recorded, and the Hamilton Rating Scale for Anxiety and the state anxiety scale of Spielberger's State-Trait Anxiety Inventory were evaluated once a week in 28 patients with generalized anxiety disorder. The Taylor Manifest Anxiety Scale and the trait anxiety scale of Spielberger's State-Trait Anxiety Inventory were used to assess anxiety before and after the tests. The present results suggest that the appearance of Fmθ might be closely related to an improvement in the anxiety symptoms associated with generalized anxiety disorder.