Effects of superoxide dismutase on liver regeneration in rats

This study was performed to clarify the effects of superoxide dismutase (SOD) on liver regeneration in rats. After about 70% hepatectomy, changes of lipid peroxides (LPO) in the remaining liver tissue, regeneration rate, mitotic index, serum transaminases and ketone body ratio (KBR) were measured under the treatment with and without SOD. The maximal value of LPO of the control group was 14.87 +/- 2.28 nmol/mg protein on the first postoperative day. In contrast, the value in the SOD-treated group was 12.14 +/- 2.38, which was significantly lower than that of the control group. The regeneration rate in the SOD-treated group had been significantly higher than that of the control group from the 4th postoperative day until 4 weeks after the operation when the experiment ended. The mitotic index of the SOD-treated group was also higher than that of the control group on the 2nd postoperative day. Although there was no significant difference in the values of KBR between two groups, the levels of transaminases in the SOD-treated group were significantly lower than those in the control group. These results indicate that SOD treatment suppresses the lipid peroxidation which cause cellular damage after hepatectomy, and hence the mitosis of the liver cell and the liver regeneration can be enhanced.     

Differential diagnosis of kidney transplant rejection and cyclosporin/tacrolimus nephropathy using urine cytology

Abstract: A total of 9000 urine samples from 69 kidney transplant recipients were studied for differential diagnoses of transplant rejection and cyclosporin/tacrolimus toxicity. New–Sternheimer and Papanicolaou staining were used to differentiate cells in urine. We also employed an immunocytochemical technique for further identification of exfoliated cells. With New–Sternheimer and Papanicolaou staining, the predominance of proximal tubular cells was useful to differentiate cyclosporin/tacrolimus toxicity from acute rejection in cases of increased serum creatinine level. During rejection episodes, an increased number of mononuclear cells and renal epithelial cells were found. Immunocytochemical analysis showed a significant increase of CD2-, CD4- CD8-, CD25- and HLA-DR-positive cells with rejection. However, there was no relationship between Banff criteria rejection grade and the increase of mononuclear cells.     

Geriatric nutritional risk index as an easy-to-use assessment tool for nutritional status in hepatocellular carcinoma treated with atezolizumab plus bevacizumab

Aim

The present study focused on Geriatric Nutritional Risk Index (GNRI), which is based on bodyweight and serum albumin, and known as an easy-to-use nutritional assessment tool in clinical settings, to elucidate the prognostic predictive ability of GNRI in patients treated with atezolizumab plus bevacizumab (Atez/Bev) for hepatocellular carcinoma (HCC).

Methods

A total of 525 HCC patients treated with Atez/Bev, based on their classification of unsuitable status for curative treatments and/or transarterial catheter chemoembolization, were enrolled (Child–Pugh A:B:C = 484:40:1, Barcelona Clinic Liver Cancer stage 0:A:B:C:D = 7:25:192:283:18). Prognosis was evaluated retrospectively using GNRI.

Results

Atez/Bev was used in 338 of the present cohort as first-line systemic chemotherapy (64.4%). Median progression-free survival based on GNRI indicating normal, mild decline, moderate decline, and severe decline was 8.3, 6.7, 5.3, and 2.4 months, respectively, whereas median overall survival was 21.4, 17.0, 11.5. and 7.3 months, respectively (both p < 0.001). The concordance index (c-index) values of GNRI for predicting prognosis (progression-free survival/overall survival) were superior to those of Child–Pugh class and albumin-bilirubin grade (0.574/0.632 vs. 0.527/0.570 vs. 0.565/0.629). As a subanalysis, muscle volume loss was observed in 37.5% of 256 patients with computed tomography data available. Along with GNRI decline, frequency of muscle volume loss became progressively larger (normal vs. mild vs. moderate vs. severe = 17.6% vs. 29.2% vs. 41.2% vs. 57.9%, p < 0.001), and a GNRI value of 97.8 was predictive of its occurrence (AUC 0.715, 95% CI 0.649–0.781; specificity/sensitivity = 0.644/0.688).

Conclusion

These findings indicate that GNRI is an effective nutritional prognostic tool for predicting prognosis and muscle volume loss complication in HCC patients treated with Atez/Bev.     

Late foreign-body reaction to PLLA screws used for fixation of acetabular osteotomy

A 31-year-old woman underwent rotational acetabular osteotomy for acetabular dysplasia. At surgery, the acetabular fragment and the grafted bone were fixed with PLLA screws. One year 7 months after surgery, the patient returned to our clinic with acute swelling and pain with sinus formation. Based on the diagnosis of an infection, local debridement was performed. Histological examination of the debrided tissue revealed inflammatory cells; however no organism was found growing on the bacterial culture. During subsequent attempts to drain the lesion, we found small PLLA particles. Thus, we diagnosed the condition as a continued inflammatory process due to foreign-body reaction to the fragmented screw material. After a repeat debridement, the inflammation subsided. At the final follow-up two years after the last procedure, there was no recurrence and the patient had returned to regular activities. This report represents the first case of a severe local reaction to PLLA implants at and around the major joints.     

Electroclinical correlation examined by simultaneous VTR-EEG monitoring in a patient with complex partial status epilepticus

We discussed the electroclinical correlation of complex partial status epilepticus (CPSE) followed by simultaneous VTR-EEG monitoring. An eight-year-old boy had repetitive seizures lasting for 30 to 90 minutes in addition to ordinary seizures with typical oral automatism of a few minutes duration. This case fulfilled the criteria for diagnosis of CPSE by Treiman et al. (1983), and was classified as the discontinuous type of CPSE described by Gastaut et al. (1975). The clinical symptoms were characterized by a repeated occurrence of psychomotor arrest and automatic phases. The EEG showed an alternate appearance of two phases. One was characterized by 7 to 8 Hz theta or slow alpha waves and the other by 4 to 6 Hz theta waves, respectively.     

Assessment of acute myocardial infarction in Japan by the Japanese Coronary Intervention Study (JCIS) Group.

BACKGROUND: Until now, large-scale nationwide surveys of acute myocardial infarction (AMI), such as those performed in Europe and America, have not been performed in Japan. Therefore, in 2000 the Japanese Coronary Intervention Study (JCIS) group conducted a nationwide survey on the incidence of AMI in Japan. METHODS AND RESULTS: Questionnaires were collected from 8,268 facilities throughout Japan. The total annual number of patients with AMI was 66,459 (52.4 patients/10(5) population), and the AMI incidence rate in Japan was approximately 25% of that in the United States. Most facilities with AMI patients treated less than 50 AMI patients annually, and that number was 45.0% of total AMI patients. The incidence of AMI patients was highest in Kochi, Kumamoto, and Wakayama prefectures, and lowest in Yamanashi, Saitama and Shiga prefectures. The ratio of the highest incidence to the lowest incidence was 2.0. A significant correlation was observed between the mean age of the prefectural population, as a coronary risk factor, and the incidence of AMI. CONCLUSIONS: The incidence of AMI in Japan is approximately 25% that in the United States and it varies considerably among the prefectures, one of the causes being the difference in the mean age. This provides important information for assessing the guidelines for Japanese patients with AMI.     

Patterns of thermoregulation associated with cold intolerance after digital replantation

Twelve patients with complete thumb amputations were analyzed to determine the interrelations between thermoregulation for pain and cold intolerance and sensory nerve recovery. Patients were examined at 3 months, 6 months, 1 year, and after 2 years following replantation. Medical thermography was introduced to assess postoperative circulation following digital replantation, while vasomotor tone was assessed by cold-stress plethysmography testing. Postoperative circulation was divided into two different patterns based upon skin temperature, the transition of which over time correlated well with sensory nerve recovery. Patients with cold intolerance showed a persistent vasoconstriction pattern, the cold change of which was objectively detected by thermography. © 1995 Wiley-Liss, Inc.     

Use of fibrin glue to minimize bleeding of microvascular repairs in hypertensive rats.

The purpose of this study is to describe our technique of applying fibrin glue at the microvascular anastomotic site and to evaluate the effect of fibrin glue on anastomotic hemostasis and patency under various high pressure states using dopamine-induced acute hypertension in rats. A total of 72 male Wistar Kyoto rats, 10 weeks old, were used in this study. Under urethane anesthesia, end-to-end anastomosis of the left femoral artery was performed using 10-0 nylon suture by the standard interrupted suture technique. Pasteurized fibrin glue was then topically applied upon the suture line of the anastomosis. Thirty-six normotensive rats were divided into three groups based on the number of sutures (4, 6, or 8) used to complete the anastomosis. Groups were subdivided, half receiving fibrin glue application and half without. Thirty-six dopamine-induced acutely hypertensive rats were divided into three groups based on the blood pressure levels of 150, 200, and 250 mmHg, respectively. These groups were again subdivided, with half receiving glue applications. Microvascular anastomosis was performed using 6 nylon sutures. Patency rates and anastomotic bleeding were evaluated. The results revealed that successful anastomoses could be performed with fewer sutures when fibrin glue was used as a reinforcement at the anastomosis. Fibrin glue was also effective at the maximum blood pressure (250 mmHg) with no anastomotic leakage and no decrease in postoperative patency rate. These results suggest that conventional microsurgical suturing technique combined with fibrin glue would be effective in the prevention of leakage in microsurgical repairs, even under conditions of high blood pressure.