Manganese superoxide dismutase content and localization in human thyroid tumours

Manganese-containing superoxide dismutase (Mn-SOD) content and its immunohistochemical localization in human thyroid tumours and some other thyroid diseases were examined and compared with adjacent normal thyroid tissue. Enzyme-linked immunosorbent assay (ELISA) was used in this study for the measurement of Mn-SOD. The content of Mn-SOD tended to increase in diffuse hyperplasia, adenomatous goitre, and foliicular adenoma. In papillary carcinoma, it was significantly higher than in adjacent normal thyroid tissue. Foliicular carcinoma also revealed a markedly high Mn-SOD conient. In the immunohistochemicai study, adjaceni normal thyroid tissue showed granular positive staining of Mn-SOD in the cytoplasm. An increase of Mn-SOD was observed in the papillary proliferative lesion of diffuse hyperplasia and in the follicles adjacent to lymphoid tissue in chronic thyroiditis with hypothyroidism. Strong positive staining of Mn-SOD was observed in papillary and foliicular carcinomas, whereas in anaplastic carcinoma staining was markedly less intense. These results indicate that the Mn-SOD content varies according to the degree of differentiation of thyroid carcinomas.     

Oral L-glutamine therapy for sickle cell anemia: I. subjective clinical improvement and favorable change in red cell NAD redox potential

Previously, we demonstrated that there is an increased utilization of glutamine by intact sickle red blood cells (RBC) in conjunction with nicotinamide adenine dinucleotide (NAD) metabolism in vitro. In this report, we describe the in vivo effect of L-glutamine supplementation on total NAD, nicotinamide adenine dinucleotide reduced (NADH), and NAD redox potential of sickle RBC. Seven adult sickle cell anemia patients participated in this study. The exclusion criteria were pregnancy, previous or current use of hydroxyurea, and transfusion within 3 months of initiation of the study. After proper consent, L-glutamine was started at a dose of 30 g/day administered orally. Fasting blood samples were drawn at baseline and after 4 weeks of therapy by routine phlebotomy for evaluation of RBC total NAD and NADH levels. We found significant changes in both the NADH level and NAD redox potential (ratio of NADH to NAD⁺ + NADH). NAD redox potential increased from 47.2 ± 3.7% to 62.1 ± 11.8% (P < 0.01). The NADH level increased from 47.5 ± 6.3 to 72.1 ± 15.1 nmol/ml RBC (P < 0.01). The total NAD level demonstrated an upward trend (from 101.2 ± 16 to 116.4 ± 14.7 nmol/ml RBC) but this was not statistically significant. Our data show that oral L-glutamine can significantly increase the NAD redox potential and NADH level in sickle RBC. These changes may decrease oxidative susceptibility of sickle RBC and result in clinical benefit. Am. J. Hematol. 58:117–121, 1998. © 1998 Wiley-Liss, Inc.     

Morphological observation by intravascular ultrasound in superior vena cava syndrome after pacemaker implantation

We report a case of superior vena cava (SVC) syndrome that was assessed by intravascular ultrasound (IVUS). A highly echogenic eccentric lesion was demonstrated by IVUS. The use of IVUS also confirmed in vivo that SVC syndrome following pacemaker insertion occurs as a result of intimal thickening of the venous wall. © 1996 Wiley-Liss, Inc.     

Three electrophysiological classes of guinea pig sympathetic postganglionic neurone have distinct morphologies

Sympathetic postganglionic neurones can be differentiated electrophysiologically into three classes (phasic, Ph; tonic, T; and long-afterhyperpolarising, LAH) based on their potassium channel expression and consequent differences in excitability. We tested whether neuronal morphology differs between these classes. Neurones in coeliac, inferior mesenteric, and lower lumbar paravertebral ganglia of guinea pigs were filled with biocytin during in vitro experiments in which electrical properties were recorded. The dimensions of somata and dendrites were measured in approximately equal numbers of stained neurones of each class. The three electrophysiological classes were distinct in terms of soma shape, soma size (Ph < T = LAH), total dendritic length (LAH < Ph < T) and average length of dendrites (LAH < Ph < T) (P < 0.0001, multivariate analysis of variance). The mean number of primary dendrites also differed (LAH 13, Ph 16, T 20). The majority of dendrites did not branch, the ratios of terminations to primary dendrites being 1.36 (LAH), 1.63 (Ph) and 1.81 (T). Overall, LAH neurones, with medium-sized somata but the smallest dendritic trees, were more distinct morphologically than Ph and T neurones. The morphological differences between classes were not dependent on differences in location. Further, there was no apparent relation between morphology and the pattern of synaptic input each class receives. The results indicate that three distinct groups of sympathetic postganglionic neurone exist in adult guinea pigs, although more than three functions are subserved by these neurones. © 1996 Wiley-Liss, Inc.     

Usefulness of 3D-VIBE method in breast dynamic MRI: imaging parameters and contrasting effects

MR imaging (MRI) has been reported to be a useful modality to characterize breast tumors and to evaluate disease extent. Contrast-enhanced dynamic MRI, in particular, allows breast lesions to be characterized with high sensitivity and specificity. Our study was designed to develop three-dimensional volumetric interpolated breath-hold examination (3D-VIBE) techniques for the evaluation of breast tumors. First, agarose/Gd-DTPA phantoms with various concentrations of Gd-DTPA were imaged using 3D-VIBE and turbo spin echo (TSE). Second, one of the phantoms was imaged with 3D-VIBE using different flip angles. Finally, water excitation (WE) and a chemical shift-selective (CHESS) pulse were applied to the images. Each image was analyzed for signal intensity, signal-to-noise ratio (1.25*Ms/Mb) (SNR), and contrast ratio [(Ms1-Ms2)/[(Ms1+Ms2)/2]]. The results showed that 3D-VIBE provided better contrast ratios with a linear fit than TSE, although 3D-VIBE showed a lower SNR. To reach the best contrast ratio, the optimized flip angle was found to be 30 degrees for contrast-enhanced dynamic study. Both WE and CHESS pulses were reliable for obtaining fat-suppressed images. In conclusion, the 3D-VIBE technique can image the entire breast area with high resolution and provide better contrast than TSE. Our phantom study suggests that optimized 3D-VIBE may be useful for the assessment of breast tumors.     

QT interval and QT dispersion increase in the elderly during laparoscopic cholecystectomy: A preliminary study

PURPOSE: To compare the influence of a longer duration of intraperitoneal CO2 insufflation with head-up tilt on electrocardiogram indices during laparoscopic cholecystectomy between elderly and younger patients. METHODS: Twelve elderly and 12 younger patients were studied. In all patients, intraperitoneal CO2 insufflation was performed for more than 150 min in the head-up position. RR interval, QT interval, the rate-corrected QT (QTc) interval, QT dispersion (QTD) and the rate-corrected QTD (QTcD) were measured. RESULTS: The QT interval and the QTc interval increased significantly from 120 to 150 min after CO2 insufflation in the elderly. The QTD and QTcD increased significantly during CO2 insufflation in both groups. Those were significantly greater in the elderly than in younger patients from 120 to 150 min after CO2 insufflation. CONCLUSION: Longer duration of CO2 insufflation with head-up tilt is associated with a prolongation of the QT interval and the QTD in elderly patients. The clinical significance of these findings remains to be determined.     

A comparative study assessing clinical effects of naftopidil and tamsulosin hydrochloride on benign prostatic hyperplasia with overactive bladder

PURPOSE: We compared the efficacy of naftopidil with that of tamsulosin hydrochloride for 154 symptomatic benign prostatic hyperplasia (BPH) patients who also suffered from overactive bladder (OAB) symptoms. MATERIALS AND METHODS: Naftopidil and tamsulosin hydrochloride were administered for eight weeks. The international prostate symptom score (IPSS), QOL index, maximum flow rate (Q(max)), residual urine volume (RUV) and side effect profile were determined before the administration and after eight weeks of treatment. RESULTS: In the naftopidil group, seven parameters of IPSS and QOL index were improved significantly at the endpoint compared to the baseline. In the tamsulosin group, all parameters except frequency and straining were also improved. Both drugs improved the Q(max) at the endpoint, too. The RUV did not change in both groups. Naftopidil was also superior to tamsulosin hydrochloride regarding general treatment outcome by the Japanese clinical guideline of urinary disturbance. CONCLUSIONS: This study demonstrated that naftopidil was clinically efficacious in the treatment of BPH patients with OAB.     

Feasibility of a short acquisition protocol for whole-body positron emission tomography with fluorine-18 fluorodeoxyglucose

The conventional protocol for whole-body positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose (FDG) requires a total acquisition time of 40-60 min, which is inconvenient for many oncological patients owing to fatigue and discomfort. This study examined the feasibility of a short protocol for whole-body PET. A phantom containing six "hot" spheres of gradually increasing diameter (10-38 mm) was imaged using a dedicated PET scanner for 20, 40, 60, 80, 120 and 600 s at various count rates. Thirty-four patients with various neoplasms underwent whole-body emission scans for 1 min per bed position 1 h after intravenous injection of 370 MBq of FDG (short protocol). A standard simultaneous transmission-emission acquisition for 10 min per bed position was performed thereafter. The images were reconstructed using an iterative algorithm. At a count rate of 40 kcps, which is close to the average count rate obtained in a whole-body FDG PET study, the 60-s image visualised five spheres, of which the smallest was 13 mm in size. Despite the better image quality, lesion detection was not improved in images acquired for more than 60 s (80-600 s). Only three of the six spheres could be detected in images acquired for less than 60 s. In the patient study, the standard protocol visualised 120 tumour lesions, of which 93 (78%) could be detected using the short protocol. Among the non-visualised lesions, 22 (82%) were Б.5 cm in size and 17 (63%) were lymph nodes. It is concluded that the proposed short protocol for whole-body FDG PET has a reasonably high detection rate and may be suitable for patients who are unable to undergo scanning for a prolonged period. It may also be useful as a pre-scan guide before a standard whole-body acquisition.     

Aortic valve replacement in an elderly patient with factor XI deficiency

Factor XI (FXI) deficiency is rare and associated with bleeding after surgical procedures. We report a case of an 80-year-old woman with severe aortic valve stenosis. FXI deficiency was diagnosed due to prolonged activated partial thromboplastin time. Aortic valve replacement was performed using a porcine bioprosthetic valve. Intra-operation bleeding was controlled by the transfusion of a fresh frozen plasma. The postoperative course was uneventful.     

Histological study of the normal vertebral artery--etiology of dissecting aneurysms

Histological evaluation of dissecting aneurysms of the cerebral arteries has suggested that defects in the internal elastic lamina (IEL) induce dissection of the arterial wall. Dissecting aneurysms occur most frequently in the vertebral artery (VA). The present study examined sections of the normal VA to elucidate the mechanisms of arterial dissection. Bilateral VAs (20 vessels) were obtained from 10 patients who died of causes other than intracranial lesions. The VAs were detached from the VA union to the site 10 mm proximal from the point penetrating the dura mater. The VAs were cut at 5-mm intervals, and each segment was observed using modified Masson's trichrome staining for elastic fibers. The thickness of the media and adventitia significantly thinned after the origin of the posterior inferior cerebellar artery (PICA). IEL defects were observed at 35 sites in 11 vessels from six subjects. There was a high incidence of IEL defects in the extradural portion and near the origin of the PICA, areas frequently involved in arterial dissection. There was a high incidence of intimal thinning at areas of IEL defects (19 of 35), and thinning was particularly marked distal to the origin of the PICA. In the absence of intimal thickening, the vascular strength at the site of IEL defects may be reduced, which would promote the occurrence and progression of arterial dissection.