Observation of Arytenoid Movement During Laryngeal Elevation Using Videoendoscopic Evaluation of Swallowing

The purpose of this study was to confirm that the arytenoid regions dynamically adduct and extend upward toward the epiglottis during laryngeal elevation. While 14 healthy volunteers aged 19?C32?years old swallowed 5?ml of white soft yogurt in one gulp without chewing, the movement of the arytenoid regions was observed for videoendoscopic evaluation of swallowing (VE). Each moving image was stored simultaneously on videotape. A cross-sectional area surrounded by the epiglottis and the bilateral arytenoid regions (S) and the length of a straight line passing through the anterior borders of the left and right arytenoid regions (L) were measured. The relative area of the entrance in the laryngeal vestibule was calculated as [S/L ²] before the swallowing reflex (resting condition), just before laryngeal closure, and just after laryngeal closure. [S/L ²] was smaller just before epiglottal descent than at the resting condition, and became smallest just after the epiglottis started to ascend. The mean area narrowed to 37.9% of the resting area just after laryngeal closure and in the most extreme case to 8.7% of the resting area. It was demonstrated that the arytenoid regions adducted and extended up toward the epiglottis during laryngeal elevation. The technique used to measure the cross-sectional area of the entrance in the laryngeal vestibule employing VE was an effective analytical procedure.     

Evaluation of community-acquired pneumonia guidelines of Japanese Respiratory Society: differentiation of atypical pneumonia and bacterial pneumonia]

To evaluate the usefulness of differentiation of atypical pneumonia and bacterial pneumonia in the community-acquired pneumonia guidelines of the Japanese Respiratory Society, we investigated 124 cases of three atypical pneumonias (Mycoplasma pneumonia, 62 cases; Chlamydia pneumoniae pneumonia, 46 cases; Chlamydia psittaci pneumonia, 13 cases) and 403 cases of bacterial pneumonia at our hospital over seven years. Overall, the sensitivity and specificity of the criteria in the guideline were 70.4% and 91.8%, respectively. High accordance was recognized in patients under 60 years old with atypical pneumonia. Items in the criteria that included subjective factors were considered inassessable. We found that the differentiation of pneumonias in the guideline is useful for the diagnosis of atypical pneumonia among younger patients, but it should be concise and objective. We therefore propose that the criteria would be more effective if they consisted of only 4 items: age under 60 years, no underlying disorders, presence of stubborn dry cough, and normal peripheral white blood cell count.     

Hepatocyte growth factor gene transfer with naked plasmid DNA ameliorates dimethylnitrosamine-induced liver fibrosis in rats

Aim: Hepatocyte growth factor (HGF) has various biological properties, including antifibrogenic activity. In the present study, we tested the efficacy of HGF gene therapy using naked plasmid DNA in dimethylnitrosamine (DMN)-induced liver fibrosis in a rat model. Methods: Naked plasmid DNA encoding human HGF was injected once, together with a hypertonic solution, into the hepatic artery after DMN treatment on three consecutive days per week for 3 weeks. Naked plasmid DNA encoding beta-galactosidase was injected similarly in the DMN-treated control rats. DMN treatment was continued once weekly after gene transfer for additional 3 weeks. Results: The human HGF protein expression was detected in livers transfected with human HGF naked plasmid DNA, gradually decreasing by day 21. The expression of the endogenous rat HGF protein was also upregulated after human HGF gene transfer. Phosphorylation of c-Met, a HGF receptor, was detected only in livers transfected with human HGF plasmid DNA. Fibrosis was attenuated significantly in livers transfected with the human HGF plasmid. Attenuation wasaccompanied by decreased expression of alpha-smooth muscle actin. Increased portal vein pressure after treatment with DMN was suppressed significantly by HGF gene transfer. The upregulated hepatic protein expression of transforming growth factor-beta (TGF-beta) in response to DMN was markedly attenuated by HGF gene transfer accompanied by the increased protein expression for matrix metalloproteinases (MMP)-3 and -13. Conclusion: The hepatic arterial injection of human naked plasmid HGF DNA was effective in suppressing liver fibrosis induced in rats by DMN. The mechanisms by which HGF expression attenuated liver fibrosis may include the suppression of hepatic TGF-beta expression and the induction of MMP expression.     

Eradication of hepatitis C virus 1b by interferon in a health care worker with acute hepatitis following needlestick transmission from a patient with chronic hepatitis C unresponsive to interferon

Hepatitis C virus (HCV) was successfully eradicated by a short course of interferon (IFN) therapy in a nurse with acute HCV infection from a needlestick accident. The source patient had chronic hepatitis C and was a nonresponder to IFN therapy. The HCV genotype was 1b in patients, and a single point mutation (H-->R in amino acid 2218) was observed in the IFN sensitivity-determining region of the nonstructural 5A gene, in comparison with sequences of HCV-J, in HCV RNA from both the source patient (before and after IFN therapy) and the recipient (before IFN therapy). Though the strain transmitted was believed to be IFN-resistant in the patient with chronic hepatitis, the patient with acute hepatitis had a sustained response.     

Low-dose ethanol attenuates gut ischemia/reperfusion-induced liver injury in rats via nitric oxide production

BACKGROUND AND AIMS: The acute administration of low-dose ethanol was demonstrated to attenuate liver injury elicited by gut ischemia/reperfusion (I/R). Nitric oxide (NO) has been found to be a modulator of adhesive interactions between leukocytes, platelets, and endothelial cells, but there has been much controversy about the effects of ethanol on NO regulation. The objective of this study was to investigate the role of NO in ethanol-reduced hepatic microvascular dysfunction elicited by gut I/R. METHODS: Male Wistar rats were exposed to 30 min of gut ischemia followed by 60 min of reperfusion. Intravital microscopy was used to monitor leukocyte recruitment and non-perfused sinusoids (NPS). Plasma alanine aminotransferase (ALT) activities were measured 6 h after the onset of reperfusion. In another set of experiments, ethanol (10%, 1 g/kg) was administered before ischemia. RESULTS: Gut I/R elicited increases in the number of stationary leukocytes, NPS, and plasma ALT activities; all of which were attenuated by pretreatment with ethanol or an NO donor. Gut I/R caused the apoptosis of hepatocytes, which was prevented by pretreatment with ethanol. Pretreatment with an NO synthase inhibitor diminished the protective effects of ethanol. The administration of ethanol increased plasma nitrite/nitrate levels. CONCLUSION: These results suggest that low-dose ethanol attenuates the gut I/R-induced hepatic microvascular dysfunction and sequential liver injury by increasing sinusoidal NO levels.     

Cross sectional and Doppler echocardiographic evaluation of aortopulmonary shunts.

BACKGROUND--Shunt vessels were imaged and shunt flow was analysed by cross sectional and Doppler echocardiography in 12 patients who had had 14 shunt procedures (nine left Blalock-Taussig shunts, three right Blalock-Taussig shunts, one modified Waterston shunt, and one central shunt). METHODS--The shunt vessels were classified by echocardiography as uniformly patent, segmentally stenosed, and uniformly stenosed. These findings were compared with those of angiography. Also the peak flow velocities at the aortic and the pulmonary ends of the shunt vessels were measured by Doppler echocardiography and the ratio of these values was calculated for each shunt. RESULTS--Twelve (85.7%) of 14 shunt vessels were imaged along their entire length by cross sectional echocardiography. The two remaining shunt vessels were only partially imaged. In 10 patients who also had angiography the echocardiographic and angiographic images of the shunt vessels were identical. The ratio of the peak flow velocity measured at the aortic and the pulmonary ends of the shunt vessel was significantly larger in the segmentally stenosed shunt vessels than in the uniformly patent shunt vessels (p < 0.001). The ratio in the two shunt vessels only partially imaged by cross sectional echocardiography indicated that they were segmentally stenosed. CONCLUSION--The combination of cross sectional and Doppler echocardiography may be useful for determining either the patency or the morphology of an aortopulmonary shunt.     

Synthesis,Properties, and Doping Behavior of Optically Active Polythiophenes Bearing a Bornyl Group

Polythiophenes bearing a bornyl group as a side chain are synthesized. The polymers, which consist of multiple thiophenes and a substituted aromatic ring in the repeat unit, demonstrate right‐handed helicity in the film state. Results of energy level measurements show good agreement with the density functional theory calculation results for the model compounds. In situ electron spin resonance (ESR) studies indicate that increasing the number of unsubstituted thiophene units in the repeat unit increases susceptibility for the dopants. The chiral charge carriers are confirmed with ESR and circular dichroism spectroscopy measurements.

     

Quantification of Myocardial Perfusion Defect Size in Rats: Comparison between Quantitative Perfusion SPECT and Autoradiography

Purpose

Ultra-high resolution single-photon emission computed tomography (SPECT) system, using multiple pinhole collimators, has been applied to the imaging of small rodents. We aimed to compare the myocardial infarction (MI) area on quantitative perfusion single-photon emission computed tomography (QPS; Cedars-Sinai Medical Center, USA) with that on high-resolution autoradiography in rat model to determine the accuracy of perfusion defect measurement by QPS.

Procedures

After thoracotomy, rats (n?=?9) had their left coronary arteries occluded and reperfused before injection with 185 MBq [^99mTc] methoxyisobutylisonitrile ([^99mTc]MIBI) for SPECT and autoradiography. Healthy rats (n?=?28) were similarly scanned to create a normal database on which to base QPS. The MI area on SPECT images was analysed automatically by QPS software. For the autoradiography images, regions of interest for MI were set at 1 mm intervals.

Results

In normal rats, [^99mTc]MIBI accumulated throughout the left ventricles, and a polar map of ventricular perfusion showed the lowest and highest uptakes in the inferior (68 %?±?4 %) and anterior (92 %?±?5 %) walls, respectively. In the rat MI model, the percentage of polar map with reduced [^99mTc]MIBI uptake correlated strongly with the percentage of left ventricle with MI on autoradiography (r²?=?0.90).

Conclusions

QPS can quantitatively evaluate MI severity on myocardial perfusion images in rats, with comparable results to autoradiography. This widely available software could promote the development of new techniques for analysing cardiac images in small animals.