Demonstration of Entrainment and Presence of Slow Conduction During Ventricular Tachycardia in Arrhythmogenic Right Ventricular Dysplasia

During VT in two cases with arrhythmogenic right ventricular dysplasia, entrainment criteria, constant fusion beats except for the last entrainment beat, progressive fusion, and a localized conduction block associated with interruption of VT, were demon strated with rapid ventricular pacing performed during VT. Furthermore, a long conduction interval was present during entrainment from the pacing site to the earliest activation site during VT. indicating the presence of a slow conduction area. VT in these cases was, thus, due to reentry with an area of slow conduction within the circuit.     

Bile acids inhibit tumour necrosis factor α-induced interleukin-8 production in human colon epithelial cells

To clarify the regulatory mechanism of the production of various inflammatory mediators by intestinal epithelial cells, the effect of bile acids (tauroursodeoxycholate, TUDC; taurochenodeoxycholate, TCDC; and taurocholate, TC) on the cytokine-induced production of interleukin (IL)-8 in a human colon epithelial cell line (HT-29) was examined. HT-29 cells were incubated for 24 h in a culture medium containing tumour necrosis factor α (TNFα; 1 ng/mL) and/or interleukin (IL)-1 β (1 ng/mL) in the presence or absence of bile acids. The IL-8 concentration in the medium was measured by an enzyme-linked immunosorbent assay. The binding assay of TNFα was performed using [125I]-TNFα (100 pmol/L). Interleukin-8 production during incubation with TNFα was markedly reduced in the presence of 0.5 and 1 mmol/L TUDC, 0.5 and 1 mmol/L TCDC and 0.5 and 1 mmol/L TC, by 56, 85, 86, 91, 37 and 70%, respectively. The IL-8 production during incubation with IL-1ß was not significantly reduced in the presence of these bile acids. The specific binding of TNFα to cells was inhibited 33, 47, and 14% by 1 mmol/L TUDC, TCDC and TC, respectively. These findings suggest that bile acids inhibit TNFα-induced IL-8 production by the colonic cells. The suppression may be partly due to inhibition of TNFα binding to the cells by bile acids.     

A Study of Modified Betaines as Cryoprotective Additives

Abstract— Glycinebetaine and N-modified betaines have been previously shown to be effective at reducing leakage from liposomes on freeze-thaw procedures. This study involved the preparation of a series of other modified betaines and the comparison of their abilities to reduce leakage from frozen multilamellar liposomes. All the compounds investigated, with the exception of the octyl ester of betaine, reduced the degree of leakage on freezing and thawing with additive concentrations up to 0·6 m . The betaine esters were less effective than betaine as cryoprotective additives and caused an increase in the leakage from unfrozen liposomes. Taurinebetaine, a sulphobetaine, was also less effective at reducing leakage on freezing than betaine and again increased leakage from unfrozen liposomes. Increasing the number of methylene groups between the carboxylate group and the nitrogen improved the ability to reduce leakage, particularly at lower additive concentrations.     

Moment analysis of hepatic local disposition of allopurinol and oxipurinol: metabolism kinetics from allopurinol to oxipurinol in the rat isolated perfused liver

Abstract— Drug metabolism in the liver was examined by the rat isolated perfused liver using the single-pass bolus-input technique. The test compounds, allopurinol and its metabolite oxipurinol, were independently introduced into the liver from the portal vein, and the concentration profiles in the venous outflow were monitored and kinetically analysed by moment theory. The recovery ratios of allopurinol and oxipurinol after the individual administration of each drug were estimated to be 0·17 (±0·08 s.d.) and 1·03 (± 0·02 s.d.), respectively. The outflow recovery ratio of oxipurinol as the metabolite after allopurinol administration was estimated to be 0·80 (±0·07 s.d.). These results indicate that the combined outflow recovery of the precursor and the metabolite after allopurinol administration is almost 100% in the rat liver.     

Multiple glomus tumours: successful treatment with electron beam irradiation

A case is reported of a 23-year-old male with multiple glomus tumours that showed marked involution after he had electron beam therapy.     

Catheter Ablation of Ventricular Tachycardia in Patients with Right Ventricular Dysplasia: Identification of Target Sites by Entrainment Mapping Techniques

Objective: To identify target sites for radiofrequency ablation of ventricular tachycardia (VT) by entrainment mapping techniques in patients with arrhythmogenic right ventricular dysplasia. Methods: Entrainment mapping and radiofrequency ablation of eight VTs was performed in seven patients. Radiofrequency ablation was applied at 31 reentry circuits sites that were classified based on findings during entrainment. Results: By entrainment criteria the 31 sites were classified as: exit sites (n = 12), proximal sites (n = 6), and outer loop sites (n = 13). Radiofrequency current application terminated VT at 7 of 31 sites: 2 of 12 exit sites (17%), 4 of 6 proximal sites (67%), and 1 of 13 outer loop sites (8%). Conclusion: Radiofrequency ablation terminated VTs most often at sites proximal to the exit as opposed to outer loop sites and exit sites (P = 0.05). The critical isthmus for ablation of VT in right ventricular dysplasia often may be distant to the exit.     

Enhanced rectal absorption of itazigrel formulated with polysorbate 80 micelle vehicle in rat: role of co-administered esterase

Abstract— We investigated the effect of esterase on rectal absorption in the rat of itazigrel using polysorbate 80 (PS-80) micelle as a vehicle to overcome the poor aqueous solubility of itazigrel. The itazigrel formulation prepared with PS-80 increased the absorption compared with a 0·25% carmellose sodium suspension, probably by supplying the itazigrel solute to keep a high concentration at the epithelial surface. When esterase was co-administered with the formulations containing PS-80, the absorption of itazigrel from rat rectum was accelerated further, by rapid release of itazigrel from the micelle vehicle after enzymatic degradation of the PS-80 micelle.     

Impact of Intraoperative 3-Tesla MRI on Endonasal Endoscopic Pituitary Adenoma Resection and a Proposed New Scoring System for Predicting the Utility of Intraoperative MRI

The aim of this study was to evaluate the impact of 3-Tesla intraoperative high-field magnetic resonance imaging (3T-iMRI) for pituitary adenoma resection, and to propose a new scoring system for predicting the utility of 3T-iMRI. This retrospective study evaluated 82 patients with pituitary adenoma who underwent purely endoscopic endonasal resection with 3T-iMRI between 2015 and 2019. 3T-iMRI revealed unexpected residual tumor in 39 cases (47.6%), which led to further resection and contributed to upgrading of the resection level in 28 cases (34.1%), which led to gross total resection rates (GTRs) of 67.1% and near total resection of 15.9%. To construct a new scoring system, patients were divided into a discovery cohort (56 patients) and a validation cohort (26 patients). Three variables for the scoring system were selected according to a univariate analysis of the discovery cohort: the size of the tumor (>20 mm: 1 point), the presence of suprasellar tumor lobulation (1 point) and the history of previous operations (1 point). The risk of additional resection after iMRI was well stratified by this scoring system (range 0–3; p = 0.0037 for trend). Robustness of the system was confirmed in the validation cohort (0 points, 0%; 1 point, 30.8%; 2 points, 70.0%; 3 points, 100%; p = 0.0116 for trend). These results indicate that 3T-iMRI optimized the extent of resection, even with the use of an endoscope, and that the proposed scoring system is useful for predicting whether 3T-iMRI is likely to be of value for a particular patient.     

A pilot study to evaluate a new combination therapy for gastric ulcer: Helicobacter pylori eradication therapy followed by gastroprotective treatment with rebamipide

Background and Aim: Controversies remain over the need for antiulcer treatment following 1‐week eradication triple therapy for Helicobacter pylori‐positive peptic ulcers. The usefulness of combination therapy for gastric ulcers in Japanese patients, which consists of H. pylori eradication followed by gastroprotective therapy with rebamipide, was therefore evaluated. Methods: The study was conducted in 52 H. pylori‐positive patients with an endoscopically‐proven open gastric ulcer. All patients received 1‐week triple therapy (lansoprazole, amoxicillin and clarithromycin) followed by 7‐week rebamipide therapy. After completion of the combination therapy, all patients underwent evaluation of ulcer healing by endoscopy, gastric ulcer symptoms and H. pylori eradication by rapid urease test and ¹³C‐urea breath test. Results: The ulcer healing rates were 85.7% (36/42) at 8 weeks, 83.3% (30/36) in eradicated patients and 100% (6/6) in non‐eradicated patients. The overall gastrointestinal symptom‐free rate improved from 19.0% at baseline to 88.1% at 8 weeks. H. pylori was effectively eradicated in 85.7% (36/42) of patients. Conclusions: The results suggested that the combination therapy for open gastric ulcer was safe, well‐tolerated and effective. However, data from a double‐blind placebo‐controlled study is necessary to confirm these findings.     

SUPPRESSION OF PLASMA GROWTH HORMONE LEVELS WITH GLUCOSE INFUSION IN PATIENTS WITH ACROMEGALY

Intravenous glucose infusion which increased blood glucose levels over 27.8 mmol/1 suppressed plasma GH levels by 41–74% in five acromegalic patients with basal concentrations of less than 20 mu/1, but not in six patients with basal levels over 80 mu/1. Oral 100 g glucose loading had little suppressing effect in both groups. These results appear to indicate that the suppressibility with hyperglycaemia is partially retained or restored in some, if not all, patients of acromegaly with lower GH secreting activity.