Embryotoxicity of Ethanol and Acetaldehyde: Direct Effects of Mouse Embryo in Vitro

Direct embryotoxic effects of ethanol (EtOH) and acetaldehyde (AcH) on mouse embryos during early organogenesis were studied using the whole embryo culture method. Mouse embryos (Jcl-ICR) were cultured for 48 hours from day 8 & 1/2 to 10 & 1/2 (embryonic age; plug day = day 1) with EtOH- or AcH-supplemented medium. Final concentrations of EtOH ranged from 5 mM to 1 M, whereas those of AcH ranged from 0.4 μM to 400 mM. Exposure to EtOH at 500 mM or more caused early death. Growth and development in EtOH-exposed embryos were retarded as indicated by the dose-dependent decrease measured by several embryonic growth parameters. The most common EtOH-induced anomaly was exencephaly and it was observed remarkably in the 66 mM or more exposed group. Exposure to AcH at 40 μM or more caused early death. Growth and development in AcH-treated embryos were retarded as a function of dosage. The most common AcH-induced anomaly was the deformation complex of the neural tube such as transparent and prominent rhombencephalon and remarkable shortening of the posterior part of the body, with or without cyst formation. This deformation complex was observed remarkably in the 0.8 μM or more exposed group. It can be said by these results that AcH is approximately 10000 times more embryotoxic than EtOH in the early organogenetic period and both EtOH and AcH disturb the normal closure of the neural tube, but each compound affects the closure process in a different way and/or developmental stage.     

Prognostic Analysis of Recurrent Breast Cancer

A total of 138 cases of recurrent breast cancer were reviewedto search for some prognostic factors especially in terms oftypes of recurrence. Solitary and "discrete" type chest wallrecurrence presented the most favorable prognosis, giving an88% survival rate at five years after recurrence, whereas multiple,disseminated and erysipelatoid type chest wall recurrence showedthe poorest prognosis without any five-year survivors. It wasalso suggested that regional lymphatic recurrence was not asunfavorable as was expected, giving a 49% five-year survivalrate. In cases of remote metastatis the five-year survival ratewas 11 % and no significant difference in prognosis was noticedamong site-specific subgroups of remote recurrence. No significanteffect of previous adjuvant radiotherapy on survival after recurrencewas found and there was no correlation between the latent periodand length of survival after recurrence.     

Hemodialysis machine with one-touch volume replacement and one-touch hemodialysis completion

In order to encourage the spread of home hemodialysis, we have developed a hemodialysis machine that enables “one-touch” voluem replacement and “one-touch” hemodialysis completion, by modifying a viscous pump-type hemodialysis machine. When emergency volume replacement is needed, pressing the volume replacement button will serve to transfer 200 ml of dialysate to the blood side as a replacement fluid, at 100 ml/min within the dialyzer. Pressing the completion procedure button when the hemodialysis is over causes 420 ml of the dialysate to be transferred to the blood side, at 100 ml/min within the dialyzer, so that the blood within the dialyzer and the blood tubing is replaced by the thus-transferred dialysate. The two puncture needles on the arterial and venous sides are then removed, and the hemodialysis completion procedure is finished. In a trial, the new hemodialysis machine, together with a cellulose triacetate membrane artificial kidney, was used a total of 144 times over a period of 4 months in three outpatients receiving maintenance hemodialysis. With the machine, 32 emergency volume replacements were performed. Both the hemodialysis completion and the emergency volume replacement procedure were performed uneventfully.     

Ammonium acid urate urolithiasis in Japan

AIM: Ammonium acid urate (AAU) calculi are a rare urolithiasis in developed countries but are endemic in developing countries. We assessed the features of AAU urolithiasis in Japanese patients. METHODS: We reviewed hospital charts of patients with urolithiasis who were treated with extracorporeal shock wave lithotripsy and endourological procedures at Sagamidai Hospital (Kanagawa, Japan) from January 1992 to December 2001. On the basis of the results of stone analysis with an infrared spectrophotometer, AAU stones were found. RESULTS: Of 8664 urolithiasis that we reviewed, 33 calculi (0.38%) from 29 patients contained AAU crystals. From crystallographic findings, we defined two types of AAU-containing stones: pure and mixed AAU urolithiasis. Pure AAU urolithiasis were seen in 13 stones from 10 patients and mixed AAU in 20 stones from 19 patients. We found significant differences between the groups: the pure AAU group predominantly consisted of young, thin women and the mixed group consisted of middle-aged men. Laboratory findings showed trends of low levels of serum protein, potassium, and urine pH in the pure AAU group. CONCLUSIONS: Because each type of AAU urolithiasis is associated with different patient characteristics and pathophysiological features, it is important to understand the type of AAU urolithiasis in patients with calculi.     

Optimal Programming of the Atrioventricular Delay Using the Phonocardiogram

Purpose: To predict the optimal atrioventricular (AV) delay using the phonocardiogram (PCG).
Methods: We studied 12 recipients of cardiac resynchronization therapy (CRT) system and eight recipients of dual-chamber pacemakers implanted for AV block with normal left ventricular (LV) function. The amplitude of the first heart sound (S1) was recorded by PCG and the LV outflow tract (OT) time-velocity integral (TVI) was measured by pulsed Doppler echocardiography. The AV delay was prolonged in 20-ms increments, from 60 ms to 240 ms. Ishikawa's method was used for the echocardiographic optimization of the AV delay. The relation between S1 amplitude and the AV delay was analyzed.
Results: The correlation between the amplitude of S1 and the length of AV delay showed an S-shaped curve. The AV delay at the inflection point of each patient's S-shaped curve (161.2 ± 19.5 ms) was positively correlated with the optimal AV delay determined by echocardiography (148.3 ± 16.9 ms, r = 0.83, P < 0.001). In addition, there was a positive correlation between the AV delay at the maximal TVI of LVOT (150.8 ± 22.7 ms) and the AV delay at the inflection point of the S-shaped curve (159.5 ± 24.9 ms, r = 0.87, P < 0.001). In two CRT system recipients, an optimal AV delay could not be found by echocardiography; however, an optimal AV delay could be determined by PCG.
Conclusions: A high correlation was observed between the optimal AV delay determined by phonocardiography versus echocardiography.     

Correlation between clinical and histological evaluations of the peri-implant gingiva around the single-crystal sapphire endosseous implant

The correlation between clinical periodontal parameters and histological structure of the gingiva around a single-crystal sapphire implant has been evaluated in two volunteer subjects. The implants had functioned after 6 years as the distal abutment of implant bridges in the Kennedy class II mandible. First, clinical evaluation was performed (gingival bleeding index, crevicular fluid volume, plaque index and probing depth) of the gingiva around the implant and natural teeth abutments and then a small piece of peri-implant gingiva was excised from the lingual site of the implant of each subject for histological evaluation. The clinical evaluation using the periodontal parameter indices corresponded with the histological evaluation of the peri-implant gingiva. The result suggests that it is possible for such parameters to be used in practice for judging the success of an implant.     

Epithelioid granulomas in chronic hepatitis C: A transient pathological feature

Multiple hepatic granulomas in chronic hepatitis C patients treated with alpha interferon were recently observed. To assess the presence of hepatic granulomas in chronic hepatitis C, and to determine whether their presence is related to interferon therapy or primarily related to chronic hepatitis C viral (HCV) infection, 446 liver biopsy specimens from 239 Japanese patients with chronic hepatitis C were reviewed. Well-formed non-caseating epithelioid granulomas were found in five (1.1%) of 446 liver biopsy specimens from five (2.0%) of 239 patients. All five patients had been followed up for 1 to 3 years, having between one and six liver biopsy specimens taken at intervals of 6 months to 1 year. Four of these five patients received alpha interferon therapy during the follow-up period. Hepatic granulomas were found in one of the pretherapy liver biopsy specimens in four patients and in one of the post-therapy specimens in one patient. Extensive investigation of the aetiology of hepatic granulomas yielded no conclusive findings. The presence of hepatic granulomas could not be demonstrated in follow-up liver biopsy specimens taken from the four patients who had undergone alpha interferon therapy. These findings suggest that hepatic granulomas may appear as an expression of non-specific reaction in HCV-related chronic hepatitis, and are not related to alpha interferon therapy.     

Alteration of T-Lymphocyte Subpopulations in Patients with Primary Renal Diseases and Systemic Lupus Erythematosus

Forty-eight patients with a variety of primary renal diseases and systemic lupus erythematosus (SLE) were examined for the proportion of circulating T lymphocytes bearing receptors for IgM Tμ cells) or IgG (Tγ cells). Although the control group showed strikingly similar mean values for both Tμ and Tγ cells, the whole group of patients with primary renal diseases and SLE showed a wide scatter of values. Sixteen patients with primary renal diseases and SLE had higher proportions of Tγ cells than the control group, whereas seven patients with chronic glomerulonephritis (CGN), membranoproliferative glomerulonephritis (MPGN), lipoid nephrosis (LN), and SLE showed very marked decrease in the proportions of Tγ cells in the peripheral blood. On the other hand, six out of the total group of patients had low proportions of Tμ cells in the peripheral blood. However, no consistent relationship between the proportion of Tμ and Tγ cells was found in our study. These findings indicate that there exists a heterogeneity of T-lymphocyte subpopulation distribution in some patients with primary renal diseases and SLE. The possible significance of these phenomena in the pathophysiology of renal diseases is discussed.