Studies on the polymerization of vinyl compounds in the presence of metal salts, 11. The polymerization of methyl methacrylate initiated by ferric ion and thiourea or its derivatives

The polymerization of methyl methacrylate initiated by ferric salt and thiourea in dimethyl sulfoxide solution was studied. By the substitution of hydrogen by an alkyl or aryl group in the thiourea, the rate of the polymerization decreases. The logarithm of the rate is proportional to the σ^* value of Taft's equation. The results are discussed on the basis of the IR and NMR data. It was confirmed that the polymerization is initiated by a radical produced by the reaction of the ferric ion with the isothiourea which is formed from the thiourea by tautomerization. The termination of the polymerization is also discussed based on the results of kinetic studies with different kinds and concentrations of the ferric salt.     

Studies on drug release from ointments. V. Release of hydrocortisone butyrate propionate from topical dosage forms to silicone rubber

The release of hydrocortisone butyrate propionate (HBP) from oil-in-water (o/w) cream and aqueous gels containing propylene glycol and ethanol to silicone rubber as a model for the skin was investigated. The release of HBP from o/w cream or gels was carried out under open or closed conditions at 35°C and 75% RH. The influence of the evaporation of vehicle components of the cream or gels on the release of HBP was examined. The release of HBP from o/w cream and aqueous gel containing propylene glycol under open conditions was lower than that under closed conditions, while the release of HBP from aqueous gel containing ethanol in open conditions was markedly higher than that under closed conditions. These differences in the release of HBP between open and closed conditions were related to changes in the thermodynamic activity of HBP in the vehicle during the release period. The results of HBP release under open conditions were nearly correlated with those of in vivo vasoconstrictor activity. The release method using silicone rubber under open conditions is considered to be useful for the evaluation of topical dosage forms, particularly those containing volatile components.     

Circulating blood volume in burn resuscitation

Circulating blood volume (CBV) was prospectively measured in patients with almost solely smoke inhalation injury (Group I: 10 patients) and in patients with severe cutaneous burn (Group B: 6 patients) consecutively until 96 hours after injury, to assess the effect of either injury on intravascular volume status by the pulse dye-densitometry method. All participants were treated by an ordinary fluid regimen based on the Parkland formula with an hourly urine output of 1.0 to 2.0 ml/kg for the resuscitation endpoint. CBV was also measured in 15 elective surgical patients for a control value (76.7+/-9.0 ml/kg). The level of CBV values in Group I was low, ranging from 54.4+/-6.9 ml/kg to 59.6+/-6.2 ml/kg (from 70.9% to 77.7% of control value), while in Group B from 48.5+/-5.5 ml/kg to 55.6+/-17.3 ml/kg (from 63.2% to 72.5%) until 72 hours after injury. There was no significant difference in CBV values between the two groups throughout the study period. We could elucidate the existence and extent of intravascular volume depletion in spite of optimal fluid treatment in both solely smoke inhalation injury and solely severe cutaneous burn. Almost solely inhalation injury was found to decrease CBV to less than that of severe cutaneous burn, which presumably led to the increased fluid requirement. Concerning the resuscitation endpoint in early burn treatment, this depletion in CBV must be taken in mind. Hourly urine output is speculated to be an effective and practical clue to manage a burn patient within permissive hypovolemia.     

Effect of smoke inhalation injury on fluid requirement in burn resuscitation

The effect of smoke inhalation injury on fluid requirement was assessed retrospectively. A total of 131 burn patients were classified into two groups: burn patients with smoke inhalation injury (Group IB: 73 patients) and burn patients without inhalation injury (Group B: 58 patients). Fluid resuscitation was commenced according to the Parkland formula and the infusion rate was modified to meet the main resuscitation goal of an hourly urine output of 1.0 to 2.0 ml/kg. Regression analyses were performed on the volume of fluid administered during the initial 24 hours after injury by burn size for each group. The linear equations obtained were Y (ml/kg/24 hrs) = 71.0 + 5.08 x %TBSA (Group IB) and Y = 39.7 + 5.14 x %TBSA (Group B). A substantial effect of inhalation injury on fluid requirement was speculated to be reflected in a y intercept difference of about 30 ml/kg/24 hrs. Thus, an increase in the fluid requirement related to the presence of inhalation injury was found to be independent and additional to burn injury.     

Mastoid obliteration combined with soft-wall reconstruction of posterior ear canal

To clarify the usefulness of modified soft-wall reconstruction method by combing with mastoid obliteration, 96 patients (98 ears) with their age ranging from 5 to 82 (average 51.3), including 62 ears with chronic otitis media (COM) with cholesteatoma, 18 ears with non-cholesteatomatous COM, 14 ears with postoperative cavity problem, and 4 ears with adhesive-type COM, who had soft-wall reconstruction of the posterior ear canal and mastoid obliteration using mainly bone powder following mastoidectomy, were evaluated their postoperative conditions more than a year after surgery. Overall success rate was 76.5% (75/98), and fresh cases showed better success rate (84.8%) than those with a history of multiple surgeries (69.2%). Among unsuccessful cases, crust and/or debris accumulation was observed most (nine ears), followed by persistent wet condition (seven ears), and exposure of the obliterated material (five ears), while only two ears showed a retraction pocket formation. The success rates remained almost the same among those who were followed for more than 2 and 3 years (46/61, 75% and 21/28, 75%, respectively). In 60 ears on which postoperative hearing was assessed, 41.7% showed less than 15 dB of air-bone gap (ABG), and 61.7% showed less than 20 dB of ABG. Mastoid obliteration with bone powder in combination with soft-wall reconstruction of the posterior ear canal appeared a useful method for obliterating mastoidectomized cavity especially for prevention of postoperative pocket formation. This paper was presented at the 139th Annual meeting of American Otological Society, in Chicago, IL, USA on May 20, 2006, and its abstract appeared in the Transactions of the American Otological Society, Inc.     

Isolation and characterization of human peripheral blood CD4+ T cell clones expressing gamma delta T cell receptors.

Rare T cell clones bearing both CD4 and gamma delta T cell receptors (TcR gamma delta) were obtained from human peripheral blood by cell sorting using anti-CD4 and anti-TCR delta 1 antibodies. All the clones established were reactive with anti-TcR gamma delta 1 antibody, whereas only about 20% of the clones showed reactivity with anti-delta TCS1 antibody. Unlike most CD4+ T cells bearing TcR alpha beta, all the clones tested showed lectin-dependent and anti-CD3 antibody-redirected cytolytic activity. About 60% of the clones exhibited natural killer cell-like activity. Immunoprecipitation analysis of TcR gamma delta showed that each clone expressed either a disulfide-linked or non-disulfide-linked heterodimer consisting of 37-44-kDa TcR gamma and TcR delta chains.     

Malignant lymphoma of the esophagus associated with macroglobulinemia: Report of a case

A case of non-Hodgkin's lymphoma of the esophagus in a 74 year old man is presented. Grossly, the surgically removed esophagus had a fuslform submucosal mass covered with smooth surfaced mucosa. Microscopic examination revealed that the mass consisted of a dense infiltrate of small to medium-sized lymphoid cells with plasmacytoid differentiation, leading to a diagnosis of diffuse small cell lymphoma with lymphoplasmacytic subtype. Laboratory data as well as immunohistochemical studies proved that the lymphoma produced monoclonal immunoglobulin M, giving rise to macroglobulinemia.     

Organization and distribution of the upper and lower esophageal motoneurons in the medulla and the spinal cord of the rat

The upper cervical esophagus is exerted on swallowing and peristalsis by somatic and visceral motoneurons, whereas the lower esophagus is exerted on only peristalsis by visceral motoneurons. We examined the origin of the esophageal motoneurons and whether there were any differences between the distributions of the upper and the lower esophageal motoneurons in the medulla and the spinal cord using cholera toxin subunit b (CTb) as the retrograde tracer. Following injection of CTb into the cervical esophagus resulted in heavy labeling of the neurons in the nucleus ambiguus including the compact (AmC), semicompact (AmS) and loose (AmL) formations, and the medial column of lamina IX at the C1-C5 levels of the cervical spinal cord corresponding to the spinal accessory nucleus. A few labeled neurons were found in the inferior salivatory nucleus, the rostral division of the dorsal motor nucleus of the vagus (DMX), the accessory facial nucleus and the lateral column of lamina IX at the C2 and C3 levels. All these labeled neurons showed ChAT immunoreactivity. When CTb was injected into the cut end of the unilateral recurrent laryngeal nerve, many labeled neurons were found in the ipsilateral AmC, the AmL, and the bilateral medial column at the C1 and C2 levels. Following injection of CTb into the subdiaphragmatic esophagus resulted in heavy labeling of the neurons only in the AmC and the DMX. When CTb was injected into the sternomastoid muscle, many labeled neurons were found in the medullary reticular formation, the facial nucleus, the medial column at the C1-C3, C5 and C6 levels, and the lateral column at the C2, C3, C5 and C6 levels. Injections of a Fluoro-Gold into the cervical esophagus and a CTb into the sternomastoid muscle or the subdiaphragmatic esophagus in the same animal showed many double labeled neurons in the medial column of the accessory nucleus at the C1 and C2 levels, but no double labeled neurons in the AmC. These results indicated that the upper cervical esophagus is innervated by the visceral medullary vagal motoneurons as well as the somatic spinal accessory motoneurons. The lower esophagus is innervated only by the visceral medullary vagal motoneurons.