Treatment resistant chronic psychopathology and CT scans in schizophrenia

In order to examine the relationship between the neuroleptic resistant chronic psychopathology and CT findings in schizophrenia, 25 schizophrenics who had been treated well and were in a stable condition were assessed for positive and negative symptoms, CT findings, medication, and the clinical course of illness. Correlational analysis showed that there was a group of patients who had comparatively small ventricles and presented treatment resistant positive symptoms, and another group of patients who had larger ventricles and lacked positive symptoms. Negative symptoms showed a tendency toward positive correlation with atrophic CT changes of cortices. Literature on CT findings and symptomatology was critically reviewed. The importance of the more chronic positive symptoms correlating to CT findings in schizophrenia were discussed.     

A simple distal coronary perfusion technique in off-pump coronary artery bypass.

This communication describes the surgical technique and clinical outcomes of a simple coronary perfusion technique for use during off-pump coronary artery bypass grafting. An intra-coronary shunt tube connected to the graft conduit (saphenous vein or radial artery) with an arterial blood source (ascending aorta or right internal thoracic artery) was inserted distally via a coronary arteriotomy for temporary perfusion of six left anterior descending arteries and two right coronary arteries.     

Comparison of anti-M2-muscarinic effect of AF-DX 116 on atrioventricular nodal conduction with those of pirenzepine and atropine as antibradyarrhythmic drugs.

Selectivity of antimuscarinic actions of AF-DX 116 (AF-DX) on the atrioventricular (AV) nodal conduction was compared with those of pirenzepine and atropine by using the canine isolated, blood-perfused AV node preparation and the open-chest in situ dog heart. In the isolated AV node preparation, dose-response curves for negative dromotropic effects (prolongation of Atrio-His interval) of carbachol (CCh) injected into the posterior septal artery were shifted to the right in parallel by AF-DX, pirenzepine, and atropine with apparent pA2-values of 13, 27.5, and 0.45 microg, respectively, and slopes of the modified Schild plot of nearly unity. Meanwhile, dose-response curves for coronary vasodilator effects of CCh were shifted to the right by AF-DX, pirenzepine, and atropine with the apparent pA2 values of 68, 12.5, and 0.55 microg, respectively, but the slopes were far from unity. In the in situ open-chest heart, dose-response curves for negative dromotropic effects (prolongation of AV conduction time) of CCh given intravenously were shifted to the right in parallel by AF-DX, pirenzepine, and atropine with apparent pA2 values of 36, 32, and 1.25 microg/kg, respectively, and the slope of nearly unity, whereas dose-response curves for hypotensive effects of CCh were shifted to the right by AF-DX, pirenzepine, and atropine with apparent pA2 values of 105, 15, and 0.65 microg/kg, respectively, but the slopes of AF-DX and pirenzepine were far from unity. In addition, prolongations of AV conduction time by electrical stimulation of the left vagus nerve in the in situ heart were suppressed by AF-DX, pirenzepine, and atropine with the ID50, dose for 50% suppression, of 40, 35, and 1.9 microg/kg, respectively. These results suggest that (a) the potency of antimuscarinic actions of AF-DX on the CCh-induced negative dromotropic effects was almost equal to that of pirenzepine, and approximately 30 times less potent than atropine; (b) the M2-subtype selectivity of AF-DX was considerably higher in comparison with pirenzepine and atropine; and (c) the muscarinic receptor subtype on the canine AV node is entirely of the M2-type, but only sparsely developed in the coronary vascular beds.     

Carbonic anhydrase I and II as a differentiation marker of human and rat colonic enterocytes

Carbonic anhydrase (CA) is an enzyme that is expressed in the intestine and catalyzes the reversible hydration of CO₂ in the following reaction: CO₂+H₂O?H₂CO₃?H⁺+HCO ₃ ^? . To elucidate the association of CA expression with the differentiation of colonic enterocytes, we investigated the expression and localization of CA using a Northern blotting analysis, Western blotting analysis, and immunohistochemical staining. A Northern blotting analysis revealed an abundant expression of CA I and II mRNA in the colonic epithelial cells. However, the expression of CA III mRNA was not detected. According to the results of immunohistochemical staining of the human colonic mucosa using antisera against CA I and II, both CA I and II were localized on the cytoplasm of non-goblet columnar cells in the upper half of the crypts where more differentiated cells are located. According to the results of immunohistochemical staining of the rat colonic mucosa, neither CA I and II were detected at the new-born stage. The expression of CAs in the upper half of the crypts began to rise from 1 week after birth, and thereafter increased according to the growth of the rats. At 3 weeks after birth, the expression of CAs was almost the same as that of the adult rats. The amount of CA proteins evaluated by a Western blotting analysis revealed that the expression of CAs increased gradually until reaching a maximum level at 6 or 8 weeks. These results therefore suggest that CA I and II appear to be good markers for the differentiation of enterocytes in the colonic mucosa.     

Temporal Trends in Outcomes after Out-of-Hospital Cardiac Arrests Witnessed by Emergency Medical Services in Japan: A Population-Based Study

Objective: Survival after out-of-hospital cardiac arrests (OHCA) witnessed by emergency medical service (EMS) personnel has been insufficiently understood. The aim of this study was to evaluate temporal trends in survival after EMS-witnessed OHCAs in Japan. Methods: A nationwide, population-based, observational cohort study of consecutive adult OHCA patients with emergency responder resuscitation attempts from January 2005 to December 2012 in Japan. We assessed the trends in annual incidence, characteristics, and outcomes of OHCA patients witnessed by EMS personnel. Multiple logistic regression analysis was used to assess factors that were potentially associated with neurologically favorable outcome defined as cerebral performance category scale 1or 2. Results: During the study period, a total of 66,760 EMS-witnessed OHCAs were documented. The annual incidence rates per 100,000 persons of EMS-witnessed OHCA patients increased from 4.6 (n = 7219) in 2005 to 4.9 (n = 9256) in 2012 (p for trend = 0.035). The proportion of one-month survival with neurologically favorable outcome improved from 5.9% in 2005 to 8.6% in 2012 (p for trend < 0.001), and the proportion increased from 22.1% in 2005 to 30.2% in 2012 in cases with shockable rhythm (p for trend < 0.001). In a multivariate analysis, adults, male gender, shockable rhythm, presumed cardiac origin, and year were associated with a better neurological outcome. Conclusions: In this population, the proportion of one-month survival with neurologically favorable outcome among OHCA patients witnessed by EMS personnel significantly improved during the study period.