Bilateral popliteal artery entrapment syndrome —Report of a case—

A 15-year old female presented with bilateral popliteal artery entrapment syndrome. The left popliteal artery was completely occluded and thromboendarterectomy was performed. Angiography on passive dorsiflexion revealed compression of the right popliteal artery, although it was free of symptoms and of normal caliber. End-to-end anastomosis in the normal anatomical position without division of the medial head of the gastrocnemius muscle was performed on both sides.     

Clinical and pathophysiological evaluation of esophageal reconstructions using gastric tube and pedicled colon segment

Pathophysiological and nutritional conditions were compared after esophageal reconstruction in 15 patients with a gastric tube and in 12 patients with a pedicled colon segment for the treatment of esophageal cancer. There was no significant difference in the postoperative nutritional index, iron and vitamin B₁₂ metabolisms. On the other hand, the long gastric tube from the greater curvature of the stomach used as an esophageal substitute retained some secretory functions of both exocrine and endocrine although the effect of truncal vagotomy may have to be taken into consideration. Presented at the 28th Annual Meeting of the Japanese Association for Thoracic Surgery, November 26, 1975, Osaka. This study is supported partly by the Cancer Research Grant No. 75-8, the Ministry of Health and Welfare, Japanese Government.     

Changes in electroencephalographic activities following pressure stimulation in humans

We investigated brain activity in response to orofacial pain in 20 healthy subjects in order to characterize the relationship between pain and changes in brain function. First, the pressure pain threshold (PPT) at the styloid process of the temporal bone (Libman's point) of 20 subjects was measured by a pressure algometer. Second, electroencephalographic (EEG) changes of 20 subjects before and after 10 s of constant pressure stimulation at Libman's point were measured. These 20 subjects were divided into two groups: 10 subjects with higher PPT (high group) and 10 subjects with lower PPT (low group). EEG change in beta activity after stimulation was greater in the low group than the high group, and there was a significant negative correlation between this change and PPT, with even minor constant stimulation inducing larger EEG change in individuals highly receptive to pain. The present study demonstrated that a relative reduction in beta activity after pain stimulation was more remarkable in subjects with lower PPT than in subjects with higher PPT, and that this change was closely related to a hemispheric balance, with even minor constant stimulation inducing changes in brain waves in individuals highly sensitive to pain.     

Preventive and curative effects of acupuncture on the common cold: a multicentre randomized controlled trial in Japan

OBJECTIVE: To determine the preventive and curative effects of manual acupuncture on the symptoms of the common cold. METHOD: Students and staff in five Japanese acupuncture schools (n=326) were randomly allocated to acupuncture and no-treatment control groups. A specific needling point (Y point) on the neck was used bilaterally. Fine acupuncture needles were gently manipulated for 15 s, evoking de qi sensation. Acupuncture treatments were performed four times during the 2-week experimental period with a 2-week follow-up period. A common cold diary was scored daily for 4 weeks, and a common cold questionnaire was scored before each acupuncture treatment and twice at weekly intervals. A reliability test for the questionnaire was performed on the last day of recording. RESULTS: Five of the 326 subjects who were recruited dropped out. The diary score in the acupuncture group tended to decrease after treatment, but the difference between groups was not significant (Kaplan-Meier survival analysis, log rank test P=0.53, Cox regression analysis, P>0.05). Statistically significantly fewer symptoms were reported in the questionnaire by the acupuncture group than control group (P=0.024, general linear model, repeated measure). Significant inter-centre (P<0.001, general linear model) and sex (P=0.027, general linear model) differences were also detected. Reliability tests indicated that the questionnaire with 15 items was sufficiently reliable. No severe adverse event was reported. CONCLUSION: This is the first report of a multi-centre randomized controlled trial of acupuncture for symptoms of the common cold. A significantly positive effect of acupuncture was demonstrated in the summed questionnaire data, although a highly significant inter-centre difference was observed. Needling on the neck using the Japanese fine needle manipulating technique was shown to be effective and safe. The use of acupuncture for symptoms of the common cold symptoms should be considered, although further evidence from placebo controlled RCTs is required.     

A cryptic lysis gene near the start of the Qbeta replicase gene in the +1 frame

The maturation/lysis (A2) protein encoded by the group B single-stranded RNA bacteriophage Qbeta mediates lysis of host Escherichia coli cells. We found a frameshift mutation in the replicase (beta-subunit) gene of Qbeta cDNA causes cell lysis. The mutant has a single base deletion 73 nucleotides (nt) 3' from the start of the replicase gene with consequent translation termination at a stop codon 129-131 nt further 3'. The 43-amino acid C-terminal part of the 67-amino acid product encoded by what in WT (wild-type) is the +1 frame, is rich in basic amino acids This 67-aa protein can mediate cell lysis whose characteristics indicate that the protein may cause lysis by a different mechanism and via a different target, than that caused by the A2 maturation/lysis protein. Synthesis of a counterpart of the newly discovered lysis product in wild-type phage infection would require a hypothetical ribosomal frameshifting event. The lysis gene of group A RNA phages is also short, 75 codons in MS2, and partially overlaps the first part of their equivalently located replicase gene, raising significant evolutionary implications for the present finding.     

Transgenic mice overexpressing PACAP in pancreatic beta-cells: acute and chronic effects on insulin and glucose homeostasis

PACAP belongs to the vasoactive intestinal polypeptide (VIP)/secretin/glucagon superfamily, which also includes glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP). PACAP shares an insulinotropic property with the latter two peptides; for instance, it stimulates insulin secretion from islets in a glucose-dependent manner at femtomolar concentrations. However, the pathophysiological significance of PACAP in diabetes remains largely unknown, for several reasons, including a lack of low-molecular weight PACAP ligands and a lack of suitable animal models. As an approach to understanding PACAP's pancreatic function in vivo, we have recently generated transgenic mice overexpressing PACAP in islet beta cells under the control of human insulin promoter (Tg mice). As a consequence, it has been demonstrated that in addition to stimulating insulin secretion, PACAP has long-term effects on pancreatic endocrine cells, including proliferation of beta cells during streptozotocin-induced diabetes development as well as aging. These observations provide additional information to support the possibility that drugs associated with PACAP-signaling pathways might be of therapeutic value for the treatment of diabetes. In this review, we briefly summarize these previous studies using Tg mice and also focus on the physiological and pathophysiological roles mediated by PACAP during diabetes development.     

Topical exposure of mitomycin C reduces opacification of the residual anterior lens capsule and lenticular regeneration after vitrectomy and lensectomy in rabbits

Purpose To examine the effect of topical administration of mitomycin C (MMC) on the opacification of residual anterior lens capsule in a vitrectomized/lensectomized eye.Methods Adult Japanese albino rabbits (n=8) received two-port vitrectomy and lensectomy with or without topical administration of MMC (0.4 mg/ml) to the residual anterior lens capsule in one eye under both general and topical anesthesia. Four eyes after vitrectomy and lensectomy were exposed to MMC for 1 min and washed out with balanced salt solution. After 1 month, the anterior segment of each globe was observed with EAS-1000 in vivo under general anesthesia and then the enucleated globes were observed through the Miyake view. Histological examination was performed.Results During healing intervals in eyes without MMC exposure, regenerated lens structure of Soemmerings ring or fibrous tissue was formed in peripheral or central areas of the residual capsule, respectively. Both the anterior lens capsule opacification and lens fiber regeneration were statistically significantly reduced by MMC topical exposure.Conclusion Lens epithelial cells produce regenerated lenticular structure and fibrous tissue on the residual capsule following vitrectomy and lensectomy in rabbits. Exposure of the residual anterior capsule to MMC may be effective in reducing both its opacification and lens fiber regeneration after vitrectomy/lensectomy.Commercial relationship policy for all authors: none     

Incidence and clinical features of Giardia lamblia

To determine the incidence and clinical features of Giardia lamblia infection, we studied 1790 patients at Kochi Medical School Hospital from April 1998 to July 2001. Fecal samples were examined microscopically by the direct smear method, direct immunofluorescent assay and by Kohn's one-step staining for G. lamblia cysts. Cysts of G. lamblia were found in 17 of 1,790(0.95%) stool samples, indicating that G. lamblia infection is not rare in Kochi. The most characteristic feature was that G. lamblia-positive cases were more frequent in the advanced age group(41-79 years old) and most of the subjects (except 2 cases) with G. lamblia had no history of traveling overseas. Four subjects had symptoms related to G. lamblia infection. Thus, more attention should be given to parasitic infections in laboratory stool examinations in order to detect cyst carriers as potential sources of infection.     

Importance of preserving the apex and plication of the base in left ventricular volume reduction surgery

OBJECTIVE: Volume reduction surgery for dilated cardiomyopathy has not yielded predictable outcomes. The purpose of this study was to clarify the efficacy of modified volume reduction surgery in preserving the left ventricular apex and reducing the left ventricular diameter at the base to maintain fiber continuity. METHODS: Heart failure was induced with propranolol in 12 dogs, and the animals were randomized into 2 groups. In one group the left ventricular wall was plicated between the 2 papillary muscles from the middle to the apex (apex-sacrificing volume reduction surgery, group A, n = 6), and in the other group plication was done from the base to the middle (apex-sparing volume reduction surgery, group B, n = 6). Left ventricular function was then compared between the groups by using echocardiography and sonomicrometry crystals. RESULTS: After volume reduction surgery, the fractional area change at the base in group B was greater than that in group A (40% +/- 3% vs 27% +/- 4%, P =.003). Cardiac output in group B was better than that in group A (2.5 +/- 0.2 vs 1.8 +/- 0.2 L/min, P =.023). Left ventricular end-diastolic pressure in group A was higher than that in group B (16 +/- 2 vs 8 +/- 1 mm Hg, P =.001). Fractional shortening in the long axis, as assessed by means of sonomicrometry, was better in group B than in group A. CONCLUSIONS: Apex-sparing volume reduction surgery capable of maintaining left ventricular fiber continuity provided better left ventricular function in both the systolic and diastolic phases than apex-sacrificing volume reduction surgery in the acute heart failure model. This modification might improve the results of left ventricular volume reduction surgery.     

Baroreflex control of heart rate during heating in subjects with low orthostatic tolerance

BACKGROUND: Heat stress induces a reduction of orthostatic tolerance. The cardiovascular responses, including the cardiac baroreflex response to heat stress, were examined to test the hypothesis that subjects with orthostatically low tolerance demonstrate an impaired baroreflex control of heart rate (HR) during heat stress. METHODS: There were 44 healthy young volunteers who underwent whole body heat stress produced by a hot-water-perfused suit during supine rest for 45 min and 75 degrees head-up tilt (HUT) for 6 min. Esophageal temperature, HR, arterial pressure, and skin blood flow in the forearm and palm were measured continuously throughout the experiment. The sensitivity of the arterial baroreflex control of HR was calculated from the spontaneous changes in beat-to-beat arterial pressure and HR. RESULTS: The HUT was uneventful for 22 volunteers (higher tolerance group), but 22 volunteers (lower tolerance group) reached presyncope after 195 +/- 19 s. Esophageal temperature, HR, arterial pressure, and skin blood flow changed similarly in the two groups during heating. In the preheating condition, the sensitivity of the baroreflex control of HR did not differ significantly between the two groups. Heating did not alter the sensitivity of baroreflex control of HR in the higher tolerance group, but decreased it significantly in the lower tolerance group. Heating increased the number of heartbeats used for analysis of the baroreflex sensitivity in the higher tolerance group, but did not change it in the lower tolerance group. CONCLUSIONS: These results suggest that the impairment of vagal baroreflex control of HR during heat exposure aggravates the orthostatic intolerance in heat-stressed humans.