Effects of endoscopic variceal sclerotherapy on azygos vein blood flow and systemic haemodynamics*

The present study was designed to determine the systemic haemodynamic effects of obliterating oesophageal varices by endoscopic sclerotherapy. We evaluated systemic and splanchnic haemodynamics before and after the first course of sclerotherapy in cirrhotic patients. The baseline cardiac index was significantly correlated with baseline azygos vein blood flow (r = 0.64; P< 0.01) and the azygos vein blood flow and cardiac index significantly decreased (-33% and -16%, respectively; P< 0.01) following sclerotherapy. The systemic vascular resistance index was also increased significantly (+20%; P<0.01) in these patients. Moreover, the per cent change in azygos vein blood flow was directly correlated with that of the cardiac index (r=0.51; P< 0.03). We conclude from these findings that the obliteration of portosystemic collaterals by sclerotherapy significantly reverses hyperdynamic circulation in such patients via a decrease in cardiac preload. The blood flow of the portosystemic shunt per se is a leading contributor to the hyperdynamic circulation observed in patients with well-developed portal systemic collateral vessels.     

Gender differences in self-evaluated sleep quality and activity of middle-aged and aged subjects

Abstract In order to investigate the gender difference of sleep and activity in middle-aged and aged individuals, home-based sleep was self-evaluated for sleep quality and activity for 5 nights in 20 healthy adults (50–76 years old; 11 women, nine men). There was no significant gender difference for subjective sleep quality. However, the activity level and movement index at night were significantly higher in men than in women, and the activity level during the day was significantly lower in men than in women. The objective sleep quality of men was significantly worse than that of women, however, subjective sleep quality does not differ.     

Biopharmaceutics: Cytotoxicity of Absorption Enhancers in Caco-2 Cell Monolayers

This study was performed to evaluate the utility of absorption enhancers with reference to mucosal cell cytotoxicity. Overall assessment of the damage to plasma, lysosomal and nuclear membranes by three absorption enhancers, sodium deoxycholate, sodium caprate and dipotassium glycyrrhizinate, was performed on Caco-2 cell monolayers. The cytotoxicities of sodium deoxycholate (0.02–0.1% w/v), sodium caprate (0.1–0.5% w/v) and dipotassium glycyrrhizinate (0.5–2% w/v) were evaluated by the trypan blue-exclusion test, the protein-release test, the neutral-red assay, the DNA-propidium iodide staining test and the test for recovery of transepithelial electrical resistance (TEER) up to 24 h after treatment with each enhancer. Sodium dodecyl sulphate (SDS; 0.1% w/v), a potent surfactant, was used as positive control. SDS at this level was significantly cytotoxic whereas dipotassium glycyrrhizinate was not cytotoxic in any tests. Results from the trypan blue-exclusion and protein-release tests showed that high concentrations of sodium caprate (0.5% w/v) and sodium deoxycholate (0.1% w/v) were significantly cytotoxic to the plasma membrane. The neutral-red assay, an indicator of damage to lysosomal membranes, revealed that 0.5% (w/v) sodium caprate had no effect whereas the uptake of neutral red was slightly increased by treatment with 0.1% (w/v) sodium deoxycholate, implying that the compound had cell-growth-enhancing activity. Nuclear-membrane damage, as evaluated by the DNA-propidium iodide staining test, was severe in cell monolayers treated with 0.5% (w/v) sodium caprate compared with that induced by 0.1% (w/v) sodium deoxycholate. In the TEER recovery test, TEER failed to recover 24 h after treatment with 0.5% (w/v) sodium caprate and 0.1% (w/v) SDS, but recovered after treatment with 0.1% (w/v) sodium deoxycholate. The recovery of TEER might be related to nuclear membrane damage and cell-growth-enhancing activity. These results indicate that of the three classes of enhancer, dipotassium glycyrrhizinate was not cytotoxic and that high concentrations of sodium caprate and sodium deoxycholate could damage plasma and nuclear membranes.     

Relationship between solvent inhalation and antisocial behavior: Special emphasis on two types of violence seen in solvent abusers

Abstract Organic solvent inhalation is a serious problem among youths in Japan. It induces physical and mental disorders, and is related closely to crime and delinquency. The relationship between solvent inhalation and antisocial behavior was investigated in 75 youths. The subjects were divided into three groups according to the level of violent behavior and the time of appearance: a non-violent group, a late-onset group (violence occurred after the start of inhalation) and an early-onset group (violence had occurred before the start of inhalation). Various parameters were compared among the groups. The late-onset group showed the following characteristics: (i) the frequency of inhalation was high, and many subjects experienced hallucinations and mood changes caused by inhalation; (ii) the family environment was characterized by conflict; and (iii) the subjects had strong psychological conflicts and showed dissociative coping with frustration. The violence, psychological conflict and dissociation in this group were found to be related to the inhalation, with familial conflict as a background. The violence in the early-onset group was considered to be the manifestation of a violent personality as the frequency of inhalation and the incidence of mental symptoms were both low. The subjects in this group showed weak psychological conflict and tended to be demanding of others when attempting to cope with frustration. Two types of violent behaviors in the teenagers who inhaled solvents were identified. The violence of solvent inhalers should be managed according to the type.     

Chronic Toxicity and Carcinogenicity Studies of 1-Methylnaphthalene in B6C3F1 Mice

The carcinogenic potential of 1-methylnaphthalene (1-MN), acompound which exists widely in the environment, was investigatedin B6C3F1 mice. Groups of 50 male and 50 female mice were givendiets containing 0, 0.075, or 0.15% 1-MN for 81 weeks. Bothtreatment groups developed pulmonary alveolar proteinosis athigh incidence, with 46.0 and 34.7% of females and 46.0 and38.0% of males, respectively, being affected. Total lipid andphospholipid levels in sera and monocytes in peripheral bloodwere also significantly increased in 1-MN-treated female andmale mice in contrast with control values. The incidences ofbronchiolar/alveolar adenomas in the lungs of male mice givenboth 0.075 or 0.15% 1-MN were 26.0 and 24.0%, respectively,in both cases significantly increased in contrast with the 4.1%observed for control males. However, neither dose dependencenor significant difference in the incidences of bronchiolar/alveolarcarcinomas between 1-MN-treated and control male mice was observed.The incidences of other tumors also were similar in both 1-MN-treatedand control groups. The results of the present experiment thussuggested a possible weak carcinogenic potential of 1-MN tothe lung of male but not female B6C3F1 mice.     

Overdrive Suppression of Antegrade Conduction Over A Kent Bundle Induced by Disopyramide

Overdrive Suppression of Kent Conduction. A patient with Wolff-Parkinson-White syndrome was described in whom antegrade conduction over the Kent hundle was suppressed after termination of orthodromic tachycardia. A phenomenon indicative of overdrive suppression of conduction occurred after intravenous disopyramide, and tended to be rate and lime dependent. (J Cardiovasc Electrophysiol, Vol. 1, No. 6, pp. 512–516 December 1990)     

Contribution of Cytochrome P450 3A Pathway to Bromocriptine Metabolism and Effects of Ferrous Iron and Hypoxia-re-oxygenation on its Elimination in the Perfused Rat Liver

The contribution of the cytochrome P450 3A pathway to bromocriptine metabolism, and the effects of ferrous iron and hypoxia-re-oxygenation on its elimination, were evaluated with the perfused rat liver. Outflow profiles of bromocriptine after bolus administration were estimated by moment analysis and dispersion model analysis. Kinetic parameters were not significantly changed by troleandomycin, a P450 3A inhibitor. The inhibition of bromocriptine metabolism by troleandomycin was 5.7 ± 2.4%. These findings indicate that cytochrome P450 3A does not play an important role in bromocriptine elimination with the perfused rat liver. Elimination rate constant (k_e) values were significantly increased by ferrous iron perfusion or hypoxia-re-oxygenation. Free-radical generation can, therefore, affect bromocriptine elimination. Our observations suggest that bromocriptine might be eliminated by scavenging of free radicals in the liver.     

Skeletal Muscle Ventricles in Circulation as Aortic Diastolic Counterpulsators: Twelve-Month Update

In previous studies, we have shown that canine skeletal muscle ventricles (SMVs) of various designs could develop stroke work intermediate between that of the canine left and right ventricle. We have subsequently reported that SMVs could be used as aortic diastolic counterpulsators. In some animals the SMVs pumped blood effectively for several weeks. Thromboembolism, however, caused renal failure, which was responsible for the demise of the longest surviving animals. More recently, we have studied a group of 15 dogs that had skeletal muscle ventricles constructed from their latissimus dorsi muscle and lined with autogenously derived tissues, either pleura, pericardium or fibrous tissue induced by a Teflon mandrel. We now report on one of those animals, that has survived more than 1 year. She remains active and in apparent good health with no clinical evidence of thromboemboli. Her SMV continues to generate effective aortic diastolic counterpulsation.     

Season of birth of schizophrenics in a recent Japanese sample

Abstract  An excess of schizophrenic births in winter or early spring is a well replicated finding in studies on Western populations. However, there are few studies on Asian populations, and their results are not consistent. We examined the seasonality of schizophrenic births in Japanese subjects ( n = 1024) born between 1955 and 1960. Our results showed a significant inverse relationship between temperature and number of schizophrenic births, which is in line with the findings in Western populations. In our data, observed reduction of schizophrenic births in summer was more marked than excess births in winter. We suggest the possibility that birth in summer may have some advantage in brain growth early in life, which results in reducing the risk of developing schizophrenia.     

Radiofrequency Catheter Ablation for AV Nodal Reentrant Tachycardia Associated with Persistent Left Superior Vena Cava

Slow A V nodal pathway ablation using RF is highly effective for patients with refractory A V nodal reentrant tachycardia (AVNRT). We report three catheter ablation cases using RF current in patients associated with persistent left superior vena cava (PLSVC). Three patients with drug refractory AVNHT of common variety were involved in this study. An electrode catheter introduced through the left subclavian vein inserted directly into the coronary sinus, a typical anatomical finding of PLSVC. The ablation procedure was initially performed at the posteroinferior region of Koch's triangle. A slow pathway potential could not be found from that area; nonsustained junctional tachycardia (NSJT) did not occur during the delivery of RF current; there was failure to eliminate slow AV nodal pathway conduction. The catheter then was moved into the bed of the proximal portion of the markedly enlarged coronary sinus. A slow AV nodal pathway potential was recorded through the ablation catheter, and the delivery of RF current caused NSJT in two patients. Complete elimination of slow AV nodal pathway conduction was accomplished in these two patients by this method. No adverse effects were provoked by this procedure. Catheter ablation of the slow A V nodal pathway guided by a slow pathway potential and the appearance of NSJT was feasible and safe in the area of the coronary sinus ostium in patients associated with PLSVC.