Central distribution of afferent and efferent components of the pudendal nerve in cat

Central distribution of afferent and efferent components of the pudendal nerve was examined in the cat by the HRP method after applying HRP to the central cut end of the pudendal nerve. Retrogradely labeled neuronal cell bodies were located primarily in the feline homologue of the Onuf's X nucleus, constituting a slender longitudinal cell column in the ventral horn of the S1 and S2 cord segments. The Onuf's nucleus was present constantly from middle S1 to high S2 cord segments, and occasionally extended rostrally to high S1 or low L7, and caudally to middle S2, low S2, or high S3 cord segments. No sex differences were observed in the distribution pattern, number, and soma size of labeled neurons in the Onuf's nucleus. Transganglionically labeled dorsal root fibers were found to terminate ipsilaterally in the lamina I of the dorsal horn at levels of lower lumbar, sacral, and higher coccygeal cord segments and the gracile nucleus, and bilaterally with an ipsilateral predominance in the dorsal commissural gray and laminae III, IV, V, and VI of the dorsal horn at levels of lower lumbar, sacral, and higher coccygeal cord segments. Some labeled dorsal root fibers appeared to end ipsilaterally in the regions where the sacral parasympathetic preganglionic neurons have been shown to be located.     

A device for adsorbing unbound, unconjugated bilirubin and its effects in vitro and in a hyperbilirubinemic newborn piglet

AIMS: A novel blood purification material that we previously reported as a superantigen- and cytokine-adsorbing device (SCAD) was evaluated for its ability to adsorb unbound, unconjugated bilirubin (UUBil) in vitro and in vivo. METHODS: In albumin-containing buffer, UUBil was dissolved and circulated through the SCAD column. Also, bilirubin was infused into low-body weight newborn piglets and hemoperfused for 3 h over SCAD columns. RESULTS: In albumin-containing buffer, concentration of bilirubin decreased from 34 to 0.6 mg/dL within 5 h and the SCAD fiber turned brown, indicating that bilirubin was adsorbed onto the surface of the adsorbent and was not degraded during the circulation. Using the hyperbilirubinemia swine, clearances of total bilirubin (TBil), direct bilirubin (DBil), and indirect bilirubin (IdBil) were significantly higher (P<0.01) in the SCAD group compared with the control group. The clearances of TBil, DBil, and IdBil at 3 h after the initiation of the bilirubin infusion were 0.47, 0.53, and 0.45 mL/min, respectively, at a blood flow rate of 2.5 mL/min, and this result indicates that almost 20% of bilirubins were adsorbed to the SCAD column in a single passage. CONCLUSION: These results provide initial evidence that SCAD treatment is effective in the removal of UUBil and can be performed safely in newborn animals.     

Prognostic value of serial serum KL-6 measurements in patients with idiopathic pulmonary fibrosis

Background

The prognostic significance of serial measurements of serum KL-6 levels in patients with idiopathic pulmonary fibrosis (IPF) is unclear; hence, it was assessed in this study.

Differential diagnosis of pancreatic cancer and focal pancreatitis by using EUS-guided FNA

BACKGROUND: Despite advances in diagnostic imaging techniques, the differentiation between pancreatic cancer and focal pancreatitis remains difficult. This study evaluated the effectiveness of EUS-guided FNA in the differential diagnosis between pancreatic cancer and focal pancreatitis, with particular reference to detection of the K-ras point mutation. METHODS: The study included 62 consecutive patients with pancreatic ductal cancer and 15 patients with focal pancreatitis demonstrated as a pancreatic mass lesion by EUS. RESULTS: Sensitivity, specificity, overall accuracy, positive predictive value, and negative predictive value of cytopathologic diagnosis were 82%, 100%, 86%, 100%, and 58%, respectively. Sensitivity, specificity, overall accuracy, positive predictive value, and negative predictive value of histopathologic diagnosis were 44%, 100%, 55%, 100%, and 32%, respectively. The K-ras point mutation was found in 74% of pancreatic cancers and 0% of focal pancreatitis lesions. No complication of EUS-guided FNA was observed. CONCLUSIONS: EUS-guided FNA is useful for the differential diagnosis of pancreatic mass lesions caused by pancreatic cancer and focal pancreatitis. Analysis for the K-ras point mutation in specimens obtained by EUS-guided FNA may enhance diagnostic accuracy in indeterminate cases.     

A case of tuberculous bronchial stenosis, diagnosed after 50 years of pulmonary and laryngeal tuberculosis]

A 82-year-old woman was referred to our department for further evaluation of her atelectasis in the left lower lobe of the lung which was found under preoperative examination for a renal pelvic tumor resection. Bronchoscopic examination was performed, and a pin-hole stenosis at the orifice of the left main bronchus was detected. Tuberculous bronchial stenosis was suspected because she had pulmonary and laryngeal tuberculosis 50 years ago. The dilatation of the stenosis was supposed to be necessary in order to prevent a pulmonary complication during the perioperative period. The stenotic area was dilated using argon plasma coagulation. Eight weeks after the procedure, a bronchoscope 6mm in external diameter could pass the dilated area. We reported a rare case with tuberculous bronchial stenosis in which the patient had never experienced a severe complication for 50 years despite the pin-hole stenosis in the left main bronchus.     

Long-Term follow-up of the circadian rhythm of heart rate and heart rate variability in healthy elderly patients.

BACKGROUND: The long-term age-related changes in circadian rhythm of heart rate variability (HRV), that is, autonomic nervous activity, remain unknown in elderly people. METHODS AND RESULTS: Holter monitoring was conducted twice at an interval of 15 years in 15 healthy elderly patients (age: 70.0 +/- 4.1 years, at first monitoring, female: 10) and assessed the age-related changes in 24-h mean and hourly mean normal sinus R-R interval (mean NN), HRV (high frequency (HF) component, low frequency (LF) component and LF/HF) and the circadian rhythms. As a result, 24-h mean mean NN (0.976 +/- 0.115 vs 0.903 +/- 0.117 (s), p = 0.0019), LF/HF (1.681 +/- 0.731 vs 0.962 +/- 0.442, p = 0.0022), and LF (278.88 +/- 176.43 vs 179.19 +/- 132.33 (ms2), p = 0.0039) significantly decreased 15 years later, although 24-h mean HF (221.20+/-138.89 vs 310.78+/-296.73 (ms2), p = 0.1102) increased slightly. The hourly mean NN closely correlated with hourly HF and LF/HF throughout circadian rhythms both at first and second monitoring. In the morning hours, amplitude rates of all HRV indices increased significantly 15 years later. CONCLUSION: In elderly people, age-related changes in the 24-h mean heart rate (HR) were conversely dissociated from those of the 24-h mean HRV. However, the close correlation between hourly HR and HRV was preserved, even in very elderly patients. Additionally, the amplitude rates in HRV in the morning increased with age. These age-related changes of HR and HRV might be characteristic of elderly people.     

Characterization of the vasoinhibitory actions of KT2-230, a new benzothiazepine vasodilator derivative on isolated rabbit vascular smooth muscles: an alpha-adrenergic- and serotonergic-receptor antagonist.

1. Pharmacological properties of KT2-230 (benzothiazepine derivative), a newly synthesized vasorelaxing agent, were studied. 2. In the anesthetized dogs, KT2-230 increased the femoral and vertebral blood flow without effect on systemic blood pressure. 3. In rabbit aorta, KT2-230, methysergide and phentolamine inhibited contractile responses to 5-hydroxytryptamine. 4. The response to norepinephrine was also inhibited by KT2-230 and phentolamine. Responses to histamine were not affected by KT2-230. 5. Responses to KCl and Ca2+ in K+ depolarized aorta in Ca2(+)-free medium were inhibited by a high concentration of KT2-230. 6. In rabbit iliac artery, KT2-230 inhibited the response to caffeine in Ca2(+)-free medium. 7. KT2-230 decreased total La3(+)-resistant Ca2(+)-binding at high affinity sites. 8. These results indicate that KT2-230 inhibits alpha 1-adrenoceptors and 5-HT-receptors and at high concentrations it inhibits slow Ca2(+)-channels. KT2-230 may inhibit the Ca2(+) release from caffeine- and agonist-sensitive Ca2+ stores.